Comportamento da síndrome coronariana aguda: resultados de um registro brasileiro

FUNDAMENTO: O Brasil carece de registros multicêntricos publicados de síndrome coronariana aguda. OBJETIVO: O Registro Brasileiro de Síndrome Coronariana Aguda é um estudo multicêntrico nacional com objetivo de apresentar dados representativos das características clínicas, e manejo e evolução hospitalares dessa síndrome. MÉTODOS: Participaram 23 hospitais de 14 cidades. Foram elegíveis pacientes que se apresentaram com suspeita de síndrome coronariana aguda nas primeiras 24 horas, com quadro clínico sugestivo, associado a alterações eletrocardiográficas compatíveis e/ou marcadores de necrose. O seguimento foi realizado até o óbito ou a alta hospitalar. RESULTADOS: Entre os anos de 2003 e 2008, foram incluídos 2.693 pacientes com diagnóstico de síndrome coronariana aguda, sendo 864 (32,1%) mulheres. O diagnóstico final foi de angina instável para 1.141 (42,4%) pacientes, com mortalidade de 3,06% deles; de infarto agudo do miocárdio sem supradesnível de ST para 529 (19,6%) pacientes, com mortalidade de 6,8% deles; e de infarto agudo do miocárdio com supradesnível de ST para 950 (35,3%) pacientes, com mortalidade de 8,1% deles; tiveram diagnóstico não confirmado 73 (2,7%) pacientes, com mortalidade de 1,36% deles. A mortalidade global foi de 5,53%. O modelo de regressão logística múltipla identificou o gênero feminino (OR=1,45), o diabetes melito (OR=1,59), o índice de massa corporal (OR=1,27) e a intervenção coronariana percutânea (OR=0,70) como fatores de risco de óbito, para demografia e intervenções. Um modelo para óbito por complicações maiores identificou choque cardiogênico/Edema Agudo de Pulmão (OR=4,57), reinfarto (OR=3,48), acidente vascular cerebral (OR=21,56), sangramento grave (OR=3,33), parada cardiorrespiratória (OR=40,27) e classe funcional de Killip (OR=3,37). CONCLUSÃO: Os dados do Registro Brasileiro de Síndrome Coronariana Aguda não diferem de outros coletados fora do país. Seus achados poderão ajudar a promover um melhor planejamento e manejo do atendimento da síndrome coronariana aguda a nível público e privado.

Meiose em Rhinocricus Padbergi Verhoeff, 1938

In the present paper the behaviour of the chromosomes in the spermatogenesis of the Myriapod Rhinocricus Padbergi Verhoeff, 1938 is studied. The primary spermatocytes are provided with 10 independent bivalents which separate normally giving rise to equivalent secondary spermatocytes. No indication of sex chromosomes has been found. Fusion of two bivalents or of four, two by two, has been observed, giving origin to secondary spermatocytes with 9 and 8 chromosomes respectively, in which fused chromosomes could be discovered. For analysing the facts the chomosomes of both, primary and secondary metaphases were separately counted from a total of 190 celis of four individuals and statistically treted. The X2-test gave insignificant results. Twenty chomosomes were counted in somatic tissues. The heterochròmatic parts of the leptotene threads were usually arranged in the periphery of the nucleus. In resting nuclei chromocenters can be observed in varyng number. Their chromosomal nature is revealed by the fact that when treated by KCÑ or KNOS they begin uncoiling.

Trematódeos monogenéticos (Polistomatas) da costa brasileira I. sobre Loimos scitulus sp. n. (Loimoidae) e Tagia ecuadori (Meserve, 1938) Sproston, 1946 (Diclidophoridae)

Em continuação aos estudos dos trematódeos monogenéticos da Coleção Helmintológica do Instituto Oswaldo Cruz, descrevemos no presente trabalho uma espécie do gênero Loimos MacCallum, 1917, Loimolinae Price, 1936, loimoidae Bychowsky, 1957 que consideramos nova para a ciência, e assinalamos nova ocorrência de Tagia ecuadori (Meserve, 1938) Sproston, 1946, Tagiinae Yamaguti, 1963, Diclidophoridae Najibina & Obonikova, 1971, no Atlântico Sul. Loimos scitulus sp. n. diferencia-se das outras espécies do gênero pelos seguintes caracteres: forma e estrututra do proaptor, oótipo grande, número de testículos, posição do poro genital, filamento do ovo e forma de opistaptor. Dentre as diferenças dadas Loimos scitulus sp. n. aproxima-se de L. salpinggoides pela estrutura do proaptor, de L. secundus pela posição do poro genital; de L. winteri pelo opistaptor. Quanto aos exemplares de Tagia ecuadori por nós estudados, apesar de ter sido evidenciada uma vagina, identificamos a esta espécie, por apresentar estruturas e medidas que se enquadram nas variações dadas pelos estudiosos do grupo.

Contribuição ao conhecimento de Thubunaea dactyluris karve, 1938 (Nematoda, Spiruroidea)

Na presente nota, redescrevemos Thubunaea dactyluris karve, 1938, em novo hospedador e assinalamos a ocorrência deste gênero pela primeira vez no Brasil. O material é resultante de uma necrópsia feita em Ameiva ameiva (L.), proveniente da Praia do Anil, Município de Magé, Estado do Rio de Janeiro. Foram estudados 8 machos e 10 fêmeas. São apresentados 9 figuras e 1 quadro com as medidas correspondentes, mostrando as variações encontradas.

Nota sobre Lutzomyia (Lutzomyia) Cruzi (mangabeira, 1938), com a descrição da fêmea (Diptera, Psychodidae, Phlebotominae)

Depois de examinar o tipo de Lutzomyia (Lutzomyia) cruzi (Mangabeira, 1938), depositado na coleção do Instituto Oswaldo Cruz (Rio de Janeiro), sob o número 941, e 74 espécimens machos da mesma espécie, a maioria da localidade tipo (Camapuan, Estado de Mato Grosso do Sul), os Autores verificaram que o tufo basal do basistilo é composto de apenas quatro cerdas foliáceas, e não seis, como descrito por Mangabeira, devido á superposição dos dois basistilos no holótipo. Além disso é feita uma descrição da fêmea, até agora não conhecida, e a redescrição do macho, baseada no holótipo.

Pseudocapillaria (Ichthyocapillaria) maricaensis n. sp. (Nematoda, Capillariidae) and remarks on the helminthological fauna of Liolaemus lutzae Mertens, 1938 (Lacertilia, Iguanidae)

Pseudocapillaria (Ichthyicapillaria) maricaensis n. sp. is described from the small intestine of the lizard, Liolaemus lutzae Meterns, 1938, collected in the State of Rio de Janeiro Brazil. The author compares the new species with Capillaria crotaliRudolphi, 1819) Travassos, 1915, Capillaria freitaslenti Araujo & Gandra, 1941, Pseudocapillaria (Pseudocapillaria) amarali (Freitas & Lent, 1934) Moravec, 1952, Pseudocapillaria (Pseudocapillaria) cezarpintoi (Freitas & Lent, 1934)Moravec, 1952 and Pseudocapillaria (Ichthyocapillaria) murinae (travassos, 1914) Moravec, 1952 previously reported from lizards in Brazil. The nematode Thelandros sceleratus Travassos, 1923 and the trematode paradistomum parvissimum (Travassos, 1918) Travassos, 1919 are for the first time reported from this same host.

Isolation and Identification of 9-methylgermacrene-B as the Putative Sex Pheromone of Lutzomyia cruzi (Mangabeira, 1938) (Diptera: Psychodidae)

Lutzomyia (Lutzomyia) cruzi has been named as a probable vector of Leishmania chagasi in Corumbá, Mato Grosso do Sul, Brazil. Taxonomically L. cruzi is closely related to the L. longipalpis species complex. Females of L. cruzi and L. longipalpis are morphologically indistinguishable and associated males must be examined carefully to confirm identifications. Chemical analysis hexane extracts of male L. cruzi has revealed the presence of a 9-methylgermacrene-B (C16), a homosesquiterpene (mw 218) previously shown to be the sex pheromone of one of the members of the L. longipalpis species complex.

In vitro evaluation of the activity of aromatic nitrocompounds against Trypanosoma cruzi

Fourteen compounds were evaluated for their activity against Trypanosoma cruzi blood stream forms at the concentration of 500 µg/ml. Six compounds were active and re-tested at lower concentrations.

Dispersal of Aedes aegypti and Aedes albopictus (Diptera: Culicidae) in an urban endemic dengue area in the State of Rio de Janeiro, Brazil

Experimental releases of female Aedes (Stegomyia) aegypti and Aedes (Stegomyia) albopictus were performed in August and September 1999, in an urban area of Nova Iguaçu, State of Rio de Janeiro, Brazil, to estimate their flight range in a circular area of 1,600 m where 1,472 ovitraps were set. Releases of 3,055 Ae. aegypti and 2,225 Ae. albopictus females, fed with rubidium (Rb)-marked blood and surgically prevented from subsequent blood-feeding, were separated by 11 days. Rb was detected in ovitrap-collected eggs by atomic emission spectrophotometry. Rb-marked eggs of both species were detected up to 800 m from the release point. Eggs of Ae. albopictus were more numerous and more heterogeneously distributed in the area than those of Ae. aegypti. Eggs positively marked for Rb were found at all borders of the study area, suggesting that egg laying also occurred beyond these limits. Results from this study suggest that females can fly at least 800 m in 6 days and, if infected, potentially spread virus rapidly.

In vitro antibacterial activity of a 7-O-beta-D-glucopyranosyl-nutanocoumarin from Chaptalia nutans (Asteraceae)

Ethanolic crude extracts from the roots of Chaptalia nutans, traditionally used in Brazilian folk medicine, were screened against Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa by using the disk diffusion test technique. S. aureus with 14 mm inhibition zone was considered susceptible. E. coli and P. aeruginosa without such a zone were considered resistant. As a result of this finding, the ethanolic crude extract was fractionated on silica gel column chromatography into five fractions. The ethyl acetate fraction was active against S. aureus and Bacillus subtilis. Further column chromatography separation of the ethyl acetate fraction afforded 30 fractions, which were assayed against S. aureus. Fractions 16 and 17 showed inhibition zones with S. aureus, indicating the presence of active compounds, and were subjected to purification by repeated preparative thin layer chromatography. The pure compound 7-O-beta-D-glucopyranosyl-nutanocoumarin inhibited B. subtilis and S. aureus at concentrations of 62.5 µg/ml and 125 µg/ml, respectively. The antibacterial property of C. nutans appears to have justified its use for the treatment of wounds, which are contaminated through bacterial infections.

Comparative immunological recognition of proteins from New Guinea "C" dengue virus type 2 prototype and from a dengue virus type 2 strain isolated in the State of Rio de Janeiro, Brazil

The protein profiles of the New Guinea "C" dengue virus type 2 (DENV-2)prototype and those of a Brazilian DENV-2 isolated in the State of Rio de Janeiro in 1995 were compared. SDS-PAGE analysis showed that the virus from Rio de Janeiro expresses NS5 (93.0 kDa), NS3 (66.8 kDa) E (62.4 kDa) and NS1 (41.2 kDa) proteins differently from the New Guinea "C" virus. The immunoblot revealed specificity and antigenicity for the NS3 protein from DENV-2 Rio de Janeiro mainly in primary infections, convalescent cases, and in secondary infections in both cases and only antigenicity for E and NS1 proteins for both viruses in primary and secondary infections.

The association of genetic markers and malaria infection in the Brazilian Western Amazonian region

Almost all individuals (182) belonging to an Amazonian riverine population (Portuchuelo, RO, Brazil) were investigated for ascertaining data on epidemiological aspects of malaria. Thirteen genetic blood polymorphisms were investigated (ABO, MNSs, Rh, Kell, and Duffy systems, haptoglobins, hemoglobins, and the enzymes glucose-6-phosphate dehydrogenase, glyoxalase, phosphoglucomutase, carbonic anhydrase, red cell acid phosphatase, and esterase D). The results indicated that the Duffy system is associated with susceptibility to malaria, as observed in other endemic areas. Moreover, suggestions also arose indicating that the EsD and Rh loci may be significantly associated with resistance to malaria. If statistical type II errors and sample stratification could be ruled out, hypotheses on the existence of a causal mechanism or an unknown closely linked locus involved in susceptibility to malaria infection may explain the present findings.

Plesiophysa guadeloupensis ("Fischer" Mazé, 1883)

A description is presented of the shell and anatomic characters of the planorbid mollusk Plesiophysa guadeloupensis ("Fischer" Mazé, 1883), based on topotypic specimens from a pond in Borricaud (Grande Terre, Guadeloupe). Comparison with previous descriptions of nominal species of Plesiophysa points to its identity with P. ornata (Haas, 1938), of which it is a senior synonym.

Efficacy of a diarylheptanoid derivative against Leishmania amazonensis

The activity of several diarylheptanoid derivatives (curcuminoids) was previously evaluated against Leishmania amazonensis promastigotes and among them the most active compound was the [1-(4-methoxy-phenyl)-7-(3,4-methoxy-4-hydroxy-phenyl)-1,6-heptadien-3, 5-dione]. This derivative was chosen to be assayed in vivo in a treatment trial. For these experiments, the curcuminoid compound was used in a concentration equivalent to the IC50/24 h, obtained from the previous study. Balb/c mice were inoculated subcutaneously in the footpad with L. amazonensis infective promastigotes and 4 weeks after the inoculation, the animals were treated with different schemes, varying from 1 to 3 doses. In all the experiments, Pentamidine Isethionate was used as reference drug under the same experimental conditions. The results showed that one dose was not enough to heal the lesion, however, with 2 and 3 doses the efficiency of the assayed compound was clear. On the other hand, treatment with Pentamidine Isethionate using the three different schemes was not satisfactory when compared to the curcuminoid derivative.