Antioxidant supplementation and premature rupture of the membranes: a planned secondary analysis

OBJECTIVE: The purpose of this study was to determine if antioxidant supplementation during pregnancy reduces the incidence of premature rupture of the membranes (PROM).STUDY DESIGN: A placebo-controlled, double-blind trial was conducted. PROM and preterm PROM (PPROM) were planned secondary outcomes of the trial. Women between 12(0/7) and 19(6/7) weeks of gestation and diagnosed to have chronic hypertension or a prior history of preeclampsia were randomized to daily treatment with both vitamin C (1000 mg) and E (400 IU) or placebo.RESULTS: Outcome data for PROM were available for 697 of 739 patients. The rates of PROM (37/349 [10.6%] vs 19/348 [5.5%]; adjusted risk ratio [RR] 1.89 [95.42% CI, 1.11-3.23]; P = .015), and PPROM (16/349 [4.6%] vs 6/348 [1.7%]; RR 2.68 [1.07-6.71]; P = .025) were increased in the antioxidant group.CONCLUSION: Contrary to expectations, vitamins C and E supplementation in this dose combination may be associated with an increased risk of PROM and PPROM.

Association between atherosclerotic aortic plaques and left ventricular hypertrophy in patients with cerebrovascular events

Background and Purpose - the purpose of this research was to evaluate whether an association exists between the presence of atherosclerotic plaque in the thoracic aorta and left ventricular hypertrophy (LVH) in patients with a cerebrovascular event.Methods - We included 116 consecutive patients ( 79 men; mean age, 62 +/- 12.4 years) with previous history of stroke or transient ischemic attack in a cross-sectional study. Transthoracic echocardiogram was performed to diagnose LVH and transesophageal echocardiogram for the detection of atheromas of the thoracic aorta. Continuous variables were analyzed by Student t or Mann-Whitney tests and categorized variables by Goodman test. From the significant association of LVH and age with atheromatous disease of the aorta, an adjustment to the multivariate logistic model was made using high blood pressure history or age as covariates. All of the statistical tests were carried out at a level of 5% significance.Results - Almost half of the patients (43.1%) presented atherosclerotic lesions in the aorta. LVH was present in 90.0% of patients with plaque and in only 30.3% of patients without plaque. Using high blood pressure as a covariate, the risk of patients with LVH presenting atherosclerotic plaque in the aorta was 18.23-fold greater than the risk for patients without LVH (95% CI, 5.68 to 58.54; P < 0.0001). Adding age into the model, the risk increased to 26.36 ( 95% CI, 7.14 to 97.30; P < 0.0001).Conclusions - LVH detected by conventional echocardiogram is associated with high risk of atherosclerotic plaque in the aorta and would be used as a criterion for indication of transesophageal echocardiography in patients with previous stroke or transient ischemic attack LVH.

Some segmental features on the structure of the aortic wall of the dog

Structural features of segmental parts of the aorta of the dog were studied by light microscopy (LM) and scanning electron microscopy (SEM). The variability in the wall architecture composition and vascular thickness of the ascending (T2-3 level), thoracic (T7-8 level) and abdominal (L6-7 infrarenal level) segments of the aorta was analysed. Morphological features such as presence of intimal folds, pattern of the medial myoconnective components with segmental variations in the number of elastic lamellae, whose relative number was higher in the thoracic aorta (ascending and descending parts), compared with the abdominal aorta, and a network of connective (stromal) elements formed by elastic and collagen lamellae and fibres in the adventitia were observed. The results were discussed on a histophysiological basis, because small but significant segmental differences had been characterized in the aortic wall structure of the dog.

Contribution to the study of aortic mural structure of opossum (Didelphis albiventris)

Opossum is considered one of the most primitive mammals, with transition evolutive characteristics. In mammals, the aorta artery is referred as the main body blood vessel. The arteries wall structural organization follows a basic pattern, being contituted of three tunics: Intima, Median and Adventicial. After euthanasia, three samples of opossum had segments from the aorta artery ascendent, thoracic descending and abdominal descending portions removed, fixed in phormalin at 10% for 48 hours. Then, the material was washed in alcohol 70% several times, dehydrated in alcohois of growing concentrations, diafanized in xylol and included in "paraplast". Cuts with 5 to 7 mu m of thickness were placed in histological laminae and submitted to color methods of Hematoxilin-Eosin, Masson, Mallory and Calleja Tricromics. It was observed that in the different portions ascendent, thoracic and abdominal descending of aorta, the intima tunic presents much thick, made up of a layer of smooth muscular cells and elastic fibers, forming a limiting internal elastic membrane. In the three portions studied, the median tunic was the most evident layer, constituted of colagen fibers, smooth muscular cells arranged in a circular manner and elastic fibers, showing a variation in the mural elements proportion. It was evidenced the presence of a external elastic lamina, marking the transition between the median and adventicial tunic, formed by elastic fibers condensation. The aortic adventicial tunic showed to be little organized, having in its structure predominantely colagen fibers beans with some isolated smooth muscular fibers or in small fascicules among a few elastic fibers.

Reactivity of mesenteric and aortic rings from trained rats fed with high caloric diet

A strong association between the benefits of physical exercise on the cardiovascular disease with an improvement of the endothelium-derived relaxing factor production has been consistently shown. The purpose of this study was to evaluate the effect of exercise training associated with high caloric diet in the reactivity of rat mesenteric and aortic rings. Experimental protocol consisted of 4 weeks of high caloric diet consumption previous to 4 weeks of run training (1.2 km/h, 0% grade, in sessions of 60 min, 5 days/week). Concentrations of triglycerides, glucose, insulin and nitrite/nitrate levels were measured and atherogenic index was calculated. Concentration-response curves to acetylcholine (10 nM-100 mu M), sodium nitroprusside (100 pM-100 nM) and phenylephrine (1 nM-3 mu M) were obtained. Exercise training reduced body mass (6%) and triglyceride levels (about 54%), without changes in glucose and insulin concentrations. An improvement of endothelium-dependent relaxation responses to acetylcholine in mesenteric and aortic rings was observed in trained group. No changes were seen for sodium nitroprusside and phenylephrine. In conclusion, our study is the first to show clearly that run training promotes an improvement of the endothelium-dependent relaxing response in aorta and mesenteric rings from rats fed with high caloric diet and that is associated with increase of NO production. (c) 2006 Elsevier B.V. All rights reserved.

Aortic aneurysm surgery: problems and innovations

Um longo caminho foi percorrido desde as primeiras intervenções cirúrgicas feitas para o tratamento do aneurisma de aorta abdominal. Ao longo deste tempo, várias inovações foram criadas, no sentido de reduzir a invasividade dos procedimentos e melhorar sua segurança e durabilidade. Nesta revisão, são discutidos os principais e recentes avanços em intervenções sobre aneurismas aórticos, incluindo a restauração aórtica endovascular, a cirurgia aórtica videolaparoscópica, as técnicas híbridas convencionais e endovasculares, as técnicas combinadas videolaparoscópicas e endovasculares, bem como as perspectivas futuras, tanto para aorta torácica como abdominal. Diante de tantas transformações e evolução, o cirurgião vascular moderno terá que ter sua mente aberta para as novidades e desenvolver capacitação ampla com diferentes técnicas para proporcionar a melhor opção terapêutica para seus pacientes.

Gross anatomical study of the aortic ARC branches of the paca (Agouti paca, Linnaeus, 1766)

Foi descrita a distribuição do arco aórtico de oito animais da espécie Agouti paca, sendo duas fêmeas adultas e seis filhotes jovens (3 machos e 3 fêmeas) que foram obtidos no Setor de Animais Silvestres da Faculdade de Ciências Agrárias e Veterinárias -- Campus de Jaboticabal. Após morte natural, seus vasos arteriais foram injetados com Neoprene latex 650 (Du Pont do Brasil S.A.) coloridos e colocados em uma solução de formalina a 10%. Depois de dissecados, notou-se que o arco aórtico desses animais emite a artéria subclávia e o tronco braquiocefálico. Este último dá origem à artéria carótida comum esquerda e a um tronco, do qual surgem a artéria carótida comum direita e a artéria subclávia direita. Estas emitem, em cada antímero, a artéria vertebral, a artéria tronco costocervical, a artéria cervical superficial, a artéria axilar e a artéria torácica interna. em apenas um animal a artéria carótida comum esquerda apresenta-se na forma de um sifão, logo após sua origem na artéria subclávia direita. Nos demais animais, a artéria carótida comum esquerda apresenta um trajeto retilíneo.

Some segmental structural features of the aortic wall of domestic chicken (Gallus domesticus)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

QUANTIFICATION OF IMMUNOGLOBULIN-A IN CHORIOAMNIOTIC MEMBRANE OF PATIENTS WITH PREMATURE RUPTURE OF MEMBRANES

Objective: the proposal was to study the presence of immunoglobulin A (IgA) in the chorioamniotic membrane of healthy postpartum women with premature rupture of the chorioamniotic membrane (FROM). Method: A single radial immunodiffusion technique was used to quantify the IgA in the chorioamniotic membrane tissues. Results: the level of IgA was approximately 10 times higher in patients whose membranes had been ruptured for > 10 h (24.58 mg/dl). These results were compared with those of a previously published study where the mean of amount of IgA was 2.52 mg/dl in membranes of patients with rupture < 10 h. Our results show that IgA began to rise after 10-15 h following rupture. Conclusion: Although more studies need to be performed our data indicate that the increasing IgA in our patients after 10 h of latency probably represents the beginning of an ascending colonization of bacteria which could be the source of future infection.

AORTIC BARORECEPTORS PLAY A PREDOMINANT ROLE IN THE REGULATION OF HINDLIMB VASCULAR-RESISTANCE IN RATS

In previous studies using bilateral carotid occlusion in conscious freely moving rats we suggested that aortic baroreceptors may play a more important role in the regulation of hindlimb than in renal and mesenteric vascular resistances. In the present study we performed electrical stimulation of the aortic baroreceptor nerve and analyzed the changes in mean arterial pressure and in hindlimb, renal, and mesenteric vascular resistances. All the experiments were performed under urethan anesthesia. Unilateral electrical stimulation (3 V, 2 ms, 50 Hz) of the aortic baroreceptor nerve produced a fall in arterial pressure (-27 +/- 3 mmHg) and an important reduction in hindlimb vascular resistance (-43 +/- 5%), with an increase in renal (+3 +/- 14%) and mesenteric (+48 +/- 12%) vascular resistances. Similar changes in arterial pressure as well as in the resistance of the three vascular beds studied were also observed during electrical stimulation of the aortic baroreceptor nerve in rats with bilateral carotid baroreceptor denervation or in rats treated with methylatropine. The data obtained with electrical stimulation indicated that aortic baroreceptors play a more important role in the regulation of blood flow in hindlimb than in renal and mesenteric vascular beds.

Sino-aortic denervation causes right atrial beta adrenoceptor down-regulation

Rat isolated right atria obtained 1 wk after sinoaortic denervation were less sensitive to the chronotropic actions of beta-agonists than were tissues obtained from animals that underwent sham surgery or no surgery at all. The potencies, but not the maximal responses for two high efficacy agonists, norepinephrine and isoproterenol, were reduced about 3- to 4-fold. Sinoaortic denervation (SAD) caused about a 3-fold decrease in potency and about a 60% decrease in maximal response for a low efficacy agonist, prenalterol. The changes in the actions of these agonists occurred in the absence of any changes in the subtype of beta receptor mediating the chronotropic response. The results of analyses of the data for prenalterol showed that SAD caused a decrease in the operational efficacy of this agonist without any changes in its K-D value for beta-1 adrenoceptors. SAD had no effect on the responses of the tissue to blockade of uptake 1 and uptake 2, suggesting no compensatory changes in the removal processes caused the decreased potency. The results of radioligand binding assays showed that SAD caused a decrease in the maximal binding of I-125-cyanopindolol without altering its K-D. Also, the results of competition binding assays confirmed the lack of effect of SAD on the K-D for prenalterol. The SAD-induced changes in the actions of agonists acting at right atrial beta-1 receptors were caused by a down-regulation of beta-1 adrenoceptors, which probably occurred in response to SAD-induced increases in sympathetic tone.