Influência da circulação extracorpórea sobre as concentrações plasmáticas de atenolol

FUNDAMENTO: Os betabloqueadores são usados no tratamento da angina pectoris e outras doenças coronarianas isquêmicas, reduzindo mortalidade e eventos cardiovasculares. O atenolol é um betabloqueador hidrofílico, de absorção gastrointestinal, extensão de distribuição pequena e eliminação função renal-dependente. OBJETIVO: O objetivo deste estudo é o de determinar a variabilidade inter-individual do atenolol em pacientes coronarianos. MÉTODOS: Quantificou-se o atenolol plasmático em 6 amostras sangüíneas coletadas no pré-operatório de sete indivíduos portadores de insuficiência coronariana e indicação cirúrgica de revascularização do miocárdio, tratados cronicamente com atenolol, com doses diárias variando entre 25 a 100 mg PO. Todos os pacientes apresentavam função renal dentro da normalidade ou levemente reduzida. RESULTADOS: As concentrações plasmáticas obtidas evidenciaram decaimento monoexponencial, confirmando que o atenolol apresenta farmacocinética de primeira ordem nas doses empregadas para o controle da insuficiência coronariana grave (médias ± DP): 123 ± 56, 329 ± 96, 288 ± 898, 258 ± 85, 228 ± 79 e 182 ± 73 ng/mL, nos tempos zero, 2, 4, 6, 8 e 12 horas após a administração da dose. Registrou-se pequena variabilidade inter-pacientes nas concentrações plasmáticas de atenolol no grupo investigado tratado em regime de doses múltiplas, devido à característica hidrofílica do fármaco. Registrou-se ainda, maior persistência do atenolol nos pacientes coronarianos investigados, comparado a indivíduos saudáveis. CONCLUSÃO: Em virtude da sua cardioseletividade e baixa variabilidade, sugere-se que o atenolol deve ser empregado como fármaco de primeira escolha para o tratamento da síndrome coronariana aguda e outras doenças cardiovasculares.

O sistema apelinérgico: papel na fisiologia e patologia humanas e potenciais aplicações terapêuticas

A apelina é um peptídeo recentemente descoberto e identificado como o ligando endógeno do receptor APJ. A apelina e o receptor APJ são expressos numa grande variedade de tecidos, tais como coração, cérebro, rins e pulmões, onde a sua interação pode ter importantes efeitos fisiopatológicos. Com efeito, a última década foi fértil no esclarecimento de possíveis papéis desempenhados pela apelina na fisiologia humana, nomeadamente como peptídeo regulador dos sistemas cardiovascular, hipotálamo-hipófisário, gastrointestinal e imunitário. Um possível envolvimento da apelina na patogênese de doenças com elevada prevalência e co-morbilidades, como a hipertensão arterial, a insuficiência cardíaca e o diabete melito tipo 2, perspectivam-na como um possível alvo terapêutico a explorar no futuro. Este trabalho fornece uma visão geral dos efeitos fisiológicos da apelina e apresenta o possível papel desse peptídeo na patogênese de várias doenças, associado a implicações terapêuticas que poderão vir a ser, assim, exploradas.

Alterações gastrointestinais associadas a insuficiência cardíaca

Na última década, foram realizados vários estudos sobre alterações gastrointestinais associadas a insuficiência cardíaca crônica. Neste artigo, apresentamos revisão da literatura sobre a fisiopatologia e consequências clínicas das alterações patológicas digestivas de pacientes com insuficiência cardíaca. Anormalidades estruturais e funcionais do trato gastrointestinal, como edema da mucosa absortiva e hipercrescimento bacteriano intestinal, têm sido responsabilizadas por graves consequências clínicas. Entre essas, destacam-se caquexia cardíaca, ativação inflamatória sistêmica e anemia. Essas condições, isoladamente ou em combinação, podem levar a piora da disfunção ventricular preexistente. Embora atualmente não haja terapêutica específica direcionada às alterações gastrointestinais associadas a insuficiência cardíaca, o entendimento das anormalidades digestivas é fundamental para sua prevenção e manejo das consequências sistêmicas.

Caquexia associada à insuficiência cardíaca

Pacientes com insuficiência cardíaca frequentemente desenvolvem estado de caquexia, que constitui fator independente de redução da sobrevida. Caquexia pode ser diagnosticada quando ocorre perda de peso corporal maior que 6% do peso habitual, na ausência de outras doenças. Embora sua fisiopatologia não esteja completamente esclarecida, vários fatores parecem estar envolvidos, como diminuição da ingestão alimentar, anormalidades do trato gastrointestinal, ativação imunológica e neuro-hormonal e alteração da relação entre processos anabólicos e catabólicos. Como não há terapia específica para a caquexia associada à insuficiência cardíaca, o tratamento baseia-se no suporte nutricional, bloqueio neuro-hormonal, controle do edema e anemia e exercícios físicos. Fármacos com propriedades imunomodulatórias e anabólicas encontram-se em investigação clínica e experimental.

Neural Mechanisms and Delayed Gastric Emptying of Liquid Induced Through Acute Myocardial Infarction in Rats

Background: In pathological situations, such as acute myocardial infarction, disorders of motility of the proximal gut can trigger symptoms like nausea and vomiting. Acute myocardial infarction delays gastric emptying (GE) of liquid in rats. Objective: Investigate the involvement of the vagus nerve, α 1-adrenoceptors, central nervous system GABAB receptors and also participation of paraventricular nucleus (PVN) of the hypothalamus in GE and gastric compliance (GC) in infarcted rats. Methods: Wistar rats, N = 8-15 in each group, were divided as INF group and sham (SH) group and subdivided. The infarction was performed through ligation of the left anterior descending coronary artery. GC was estimated with pressure-volume curves. Vagotomy was performed by sectioning the dorsal and ventral branches. To verify the action of GABAB receptors, baclofen was injected via icv (intracerebroventricular). Intravenous prazosin was used to produce chemical sympathectomy. The lesion in the PVN of the hypothalamus was performed using a 1mA/10s electrical current and GE was determined by measuring the percentage of gastric retention (% GR) of a saline meal. Results: No significant differences were observed regarding GC between groups; vagotomy significantly reduced % GR in INF group; icv treatment with baclofen significantly reduced %GR. GABAB receptors were not conclusively involved in delaying GE; intravenous treatment with prazosin significantly reduced GR% in INF group. PVN lesion abolished the effect of myocardial infarction on GE. Conclusion: Gastric emptying of liquids induced through acute myocardial infarction in rats showed the involvement of the vagus nerve, alpha1- adrenergic receptors and PVN.

First- Versus Second-Generation Drug-Eluting Stents in Acute Coronary Syndromes (Katowice-Zabrze Registry)

Abstract Background: There are sparse data on the performance of different types of drug-eluting stents (DES) in acute and real-life setting. Objective: The aim of the study was to compare the safety and efficacy of first- versus second-generation DES in patients with acute coronary syndromes (ACS). Methods: This all-comer registry enrolled consecutive patients diagnosed with ACS and treated with percutaneous coronary intervention with the implantation of first- or second-generation DES in one-year follow-up. The primary efficacy endpoint was defined as major adverse cardiac and cerebrovascular event (MACCE), a composite of all-cause death, nonfatal myocardial infarction, target-vessel revascularization and stroke. The primary safety outcome was definite stent thrombosis (ST) at one year. Results: From the total of 1916 patients enrolled into the registry, 1328 patients were diagnosed with ACS. Of them, 426 were treated with first- and 902 with second-generation DES. There was no significant difference in the incidence of MACCE between two types of DES at one year. The rate of acute and subacute ST was higher in first- vs. second-generation DES (1.6% vs. 0.1%, p < 0.001, and 1.2% vs. 0.2%, p = 0.025, respectively), but there was no difference regarding late ST (0.7% vs. 0.2%, respectively, p = 0.18) and gastrointestinal bleeding (2.1% vs. 1.1%, p = 0.21). In Cox regression, first-generation DES was an independent predictor for cumulative ST (HR 3.29 [1.30-8.31], p = 0.01). Conclusions: In an all-comer registry of ACS, the one-year rate of MACCE was comparable in groups treated with first- and second-generation DES. The use of first-generation DES was associated with higher rates of acute and subacute ST and was an independent predictor of cumulative ST.

Community structure of metazoan parasites of silverside, Odontesthes bonariensis (Pisces, Atherinopsidae) from Argentina

The helminth communities of silverside, Odontesthes bonariensis (Valenciennes, 1835), from two Argentinean lagoons were studied and compared at component community and infracommunity levels. Nine helminth species were found: five digeneans (Austrodiplostomum cf. mordax, Ascocotyle (Phagicola) cf. diminuta, Ascocotyle sp., Thometrema bonariensis and Saccocoelioides sp.); two nematodes (Contracaecum sp. and Hysterothylacium sp.); one acanthocephalan (Wolffhugelia matercula) and one cestode (Cangatiella macdonaghi). Odontesthes bonariensis is a new host record for five parasite species. Richness, diversity and number of helminths in silversides from Salada Grande lagoon were higher than in those from Lacombe lagoon. This could be related with lagoon size, abundance of mollusks and fish-eating birds, and size and diet of silversides captured in each lagoon. In Salada Grande lagoon the helminth community of silversides was dominated by the allogenic and generalist species A. cf. mordax; while the autogenic and intermediate specialist species C. macdonaghi was dominant in Lacombe lagoon. Host sex did not affect richness, diversity or total abundance, whereas host size was positively correlated with these attributes, except diversity in Salada Grande lagoon.

Plastic ingestion by sea turtles in Paraíba State, Northeast Brazil

ABSTRACT Currently, plastics are recognized as a major pollutant of the marine environment, representing a serious threat to ocean wildlife. Here, we examined the occurrence and effects of plastic ingestion by sea turtles found stranded along the coast of Paraíba State, Brazil from August 2009 to July 2010. Ninety-eight digestive tracts were examined, with plastic found in 20 (20.4%). Sixty five percent (n = 13) of turtles with plastic in the digestive tract were green turtles (Chelonia mydas), 25% (n = 5) were hawksbills (Eretmochelys imbricata), and 10% (n = 2) were olive ridley (Lepidochelys olivacea). More plastic was found in the intestine (85%) than in other parts of the gastrointestinal tract. We observed complete blockage of the gastrointestinal tract due to the presence of plastic in 13 of the 20 turtles that had ingested plastic. No correlation was found between the curved carapace length (CCL) and the number or mass of the plastic ingested items. Significant differences were found between the intake of hard and soft plastic and the ingestion of white/transparent and colored plastic, with soft and white/transparent plastics being more commonly ingested. This study reveals the serious problem of plastic pollution to sea turtles at the area.

Philander opossum (Marsupialia), a new host record for Sparganum of Lueheella Baer, 1924 (= Spirometra Mueller, 1937)

Two samples of Sparganum, the larval form of Lueheella Baer, 1924 (= Spirometra Mueller, 1937) were recovered from Philander opossum (L. 1758) captured in Salobra, Mato Grosso State, Brazil, by Dr. Lauro Travassos in may, 1942. This is the first report of the presence of this larval form in P. opossum. Dealing with helminths recovered from Brazilian Marsupialia, deposited in Oswaldo Cruz Institute Helminthological Collection, we examined in two samples of the preserved material collected in Salobra. Mato Grosso State, nine larval forms (Sparganum) of Lueheella sp. One of the samples, with six specimens, tissue. It is the first report of philander opossum harbouring this larval stage. The studied preserved wet material was stained and whole mounts were deposited in the Oswaldo Cruz institute Helminthological collection ns. 31.470 and 31.471. Measurements are in mm.

Enteroparasitos em índios Yanomâmi

The findings of intestinal helminths and protozoans parasites from the Yanomâmi indians of the Roraima State in Brazil are reported. The fecal samples were collected before these communities started a permanent contact with non-indians. Comments are made on the possible ecological and evolutionary factors responsible for the patterns of parasitism observed.

Neohilgertia venusti Gen. N. SP. N. (Nematoda: Oxyuridae)from Thylamys venustus cinderellus (Thomas) Reig, Kirsch & Marshall, 1985 (Marsupialia: Didelphidae) in Burruyacu, Tucuman, Argentina - Systematic position and possible evolution

Neohilgertia gen. n. proposed for Oxyuridae nematodes from Thylamys venustus cinderellus (Marsupialia: Didelphidae) is described. The hypothesis about the possibility of a secondary parasitism for marsupials and the origin of the genus in the African Sciuridae parasite ancestors is discussed.

A new helminth parasite of fish: Spirocamallanus freitasi sp. n. (Nematoda - Camallanidae)

A new species of nematode is described, Spirocamallanus freitasi sp. n. The worms were collected from fishes (Bergiaria westermanni, Pimelodus maculatus and Pimelodus sp.) living in Três Marias Dam (São Francisco River) in the State of Minas Gerais, Brazil. Spirocamallanus freitasi sp. n. differs from Procamallanus iheringi, P. amarali, P. macaensis, P. (Spirocamallanus) pimelodus, P. (S.) solani and P. (S.) pereirai by having digitated larger spicule and from P. cruzi by having not digitated terminal parts of both spicules. It differs also from P. (S.) intermedius by having not larger spicule divided in two undigitated branches and six to nine sclerotized bands in the buccal capsule; P. rarus has three to four sclerotized bands and tridigitated larger branch of longer speicule, differing from S. feitasi sp. n.

Inhibition of gastric secretion by a water extract from Baccharis triptera, Mart

Baccharus triptera Mart, is a widespread Compositae used in Brazilian folk medicine to treat gastrointestinal disturbances, rheumatic disease, mild fever, diabetes and as an anti-helminthic. Water extract of small branches of the plant (WE) administered to mice and rats (0.1 to 2 g/Kg, p.o) did not alter spontaneous motor activity, sleeping time induced by barbiturates or the tailflick response in mice. The extract decreased by 40 por cento the number of writhings induced by 0.8 por cento scetic acid, i.p., but did not influence paw edema induced by carrageenan or dextran in rats WE (2g/Kg, p.o.) decreased the intestinal transit of charcoal in mice by 20//. Gastric secretion in pylorus ligated rats was reduced after treatment with WE (1 and 2 g/Kg. i.p. or intraduodenal and the gastric pH was raised. The extract (1 g/Kg, p.o.) prevented gastric ulcers induced in rats by immobilization at 4ºC, but not those induced by indomethacin (10 mg/Kg, s.c.). The results indicate that WE may relieve gastrointestinal disorders by reducing acid secretion and gastrointestinal hiperactivity. Neither analgesic nor anti-inflammatory activities were detectable.

Pterigodermatites (Paucipectines) spinicaudatis n.sp. (Nematoda: Rictularidae) from Dromiciops australis (Marsupialia: Microbiotheriidae) in Bariloche, Rio Negro, Argentina, biogeographical distribution and host-parasite relationships

Pterigodermatites (P.) spinicaudatis sp.n. from Dromiciops australis is proposed and described. The simple morphology of the ovijector and the presence of a well developed spine between the two cuticular projections at the caudal extremity of the female distinguish the studied nematode from the remainder species of the genus parasitizing South American Edentata, marsupials and cricetid rodents. The distribution area of the hosts of the different species of P. (P.) are given. The studied genus does not parasitize any Australian marsupials. It was found in the endemic South American Microbiotheriidae. This fact suggests from a parasitological point of view that D. australis is not related to the Australian marsupials but to the South American ones.

Esclerose de varizes do esôfago em pacientes esquistossomóticos

To assess the therapeutic possibilities of injection sclerosis in schistosomotic portal hypertension, a 5-year prospective study was conducted in northeast Brazil, where this parasitosis is endemic. Fifty patients undergoing endoscopy for upper gastrointestinal hemorrage from rupture of esophageal varices from July through December 1981 were chosen for the study. The 32 consenting patients were submitted to injection sclerotherapy paravariceally, using ethanolamine oleate; the 18 refusing to participate were assigned to the control group. The incidence of rebleeding was 28.1% in the former and 44.5% in the latter, a difference wich was not statistically significant (Fisher's test, p = 0.017). Since sclerotherapymarkedly improved the long-term survival rate of the patients, this procedure is advocated for the treatment of esophageal varices in cases of portal hypertension due to schistosomiasis.