Estudo piloto com Eco 3D das modificações geométricas do VE após infarto do miocárdio

FUNDAMENTO: Remodelamento ventricular esquerdo (RVE) após IAM caracteriza fator de mau prognóstico. Há pouca informação na literatura sobre o RVE analisado com ecocardiografia tridimensional (ECO 3D) OBJETIVO: Analisar com ECO 3D as modificações geométricas e volumétricas do ventrículo esquerdo (VE) seis meses após IAM em pacientes submetidos a tratamento primário percutâneo. MÉTODOS: Estudo prospectivo com ECO 3D de 21 indivíduos (16 homens, 56 ± 12 anos), acometidos por IAM com elevação do segmento ST. Foi feita a análise morfofuncional (VE) com ECO 3D (volumes, FEVE, índice de esfericidade 3D) até sete dias e seis meses após o IAM. RVE foi considerado para aumento > 15% do volume diastólico final do VE (VDFVE) após seis meses do IAM, comparado ao VDFVE até sete dias do evento. RESULTADOS: Oito (38%) pacientes apresentaram RVE. Medidas ecocardiográficas (n = 21 pacientes): I- até sete dias do IAM: 1- VDFVE: 92,3 ± 22,3 mL; 2- FEVE: 0,51 ± 0,01; 3- índice de esfericidade: 0,38 ± 0,05; II- após seis meses: 1- VDFVE: 107,3 ± 26,8 mL; 2- FEVE: 0,59 ± 0,01; 3- índice de esfericidade: 0,31 ± 0,05. Coeficiente de correlação (r) entre índice de esfericidade até sete dias do IAM e VDFVE aos seis meses (n = 8) após o IAM: r: 0,74, p = 0,0007; (r) entre índice de esfericidade após seis meses do IAM e VDFVE aos seis meses do IAM: r: 0,85, p < 0,0001. CONCLUSÃO: Nesta série, foi observado RVE em 38% dos pacientes seis meses após IAM. O índice de esfericidade tridimensional foi associado à ocorrência de RVE.

A Comparison of Radiation Dose Between Standard and 3D Angiography in Congenital Heart Disease

Background: The use of three-dimensional rotational angiography (3D-RA) to assess patients with congenital heart diseases appears to be a promising technique despite the scarce literature available. Objectives: The objective of this study was to describe our initial experience with 3D-RA and to compare its radiation dose to that of standard two-dimensional angiography (2D-SA). Methods: Between September 2011 and April 2012, 18 patients underwent simultaneous 3D-RA and 2D-SA during diagnostic cardiac catheterization. Radiation dose was assessed using the dose-area-product (DAP). Results: The median patient age and weight were 12.5 years and 47.5 Kg, respectively. The median DAP of each 3D-RA acquisition was 1093µGy.m2 and 190µGy.m2 for each 2D-SA acquisition (p<0.01). In patients weighing more than 45Kg (n=7), this difference was attenuated but still significant (1525 µGy.m2 vs.413µGy.m2, p=0.01). No difference was found between one 3D-RA and three 2D-SA (1525µGy.m2 vs.1238 µGy.m2, p = 0.575) in this population. This difference was significantly higher in patients weighing less than 45Kg (n=9) (713µGy.m2 vs.81µGy.m2, P = 0.008), even when comparing one 3D-RA with three 2D-SA (242µGy.m2, respectively, p<0.008). 3D-RA was extremely useful for the assessment of conduits of univentricular hearts, tortuous branches of the pulmonary artery, and aorta relative to 2D-SA acquisitions. Conclusions: The radiation dose of 3D-RA used in our institution was higher than those previously reported in the literature and this difference was more evident in children. This type of assessment is of paramount importance when starting to perform 3D-RA.

Hemodynamic Effect of Laser Therapy in Spontaneously Hypertensive Rats

Systemic arterial hypertension (SAH) is considered to be the greatest risk factor for the development of neuro-cardiovascular pathologies, thus constituting a severe Public Health issue in the world. The Low-Level Laser Therapy (LLLT), or laser therapy, activates components of the cellular structure, therefore converting luminous energy into photochemical energy and leading to biophysical and biochemical reactions in the mitochondrial respiratory chain. The LLLT promotes cellular and tissue photobiomodulation by means of changes in metabolism, leading to molecular, cellular and systemic changes. The objective of this study was to analyze the action of low-level laser in the hemodynamic modulation of spontaneously hypertensive rats, in the long term. Animals (n = 16) were randomly divided into the Laser Group (n = 8), which received three weekly LLLT irradiations for seven weeks, and into the Sham Group (n = 8), which received three weekly simulations of laser for seven weeks, accounting for 21 applications in each group. After seven weeks, animals were cannulated by the implantation of a catheter in the left carotid artery. On the following day, the systemic arterial pressure was recorded. The Laser Group showed reduced levels of mean blood pressure, with statistically significant reduction (169 ± 4 mmHg* vs. 182 ± 4 mmHg from the Sham Group) and reduced levels of diastolic pressure (143 ± 4 mmHg* vs. 157 ± 3 mmHg from the Sham Group), revealing a 13 and 14 mmHg decrease, respectively. Besides, there was a concomitant important decline in heart rate (312 ± 14 bpm vs. 361 ± 13 bpm from the Sham Group). Therefore, laser therapy was able to produce hemodynamic changes, thus reducing pressure levels in spontaneously hypertensive rats.

Morphological study of adult male worms of Schistosoma mansoni Sambon, 1907 by confocal laser scanning microscopy

Aiming to detail data obtained through brightfield microscopy (BM) on reproductive, excretory and digestive system, specimens of Schistosoma mansoni eight weeks old, were recovered from SW mice, stained with Langeron's carmine and analyzed under a confocal laser scanning microscope CLSM 410 (Carl Zeiss). The reproductive system presented a single and lobate testis, with intercommunications between the lobes without efferent duct. Supernumerary testicular lobe was amorphous and isolated from the normal ones. Collecting tubules (excretory ducts), followed by the excretory bladder, opening to the external media through the excretory pore, were observed at the posterior extremity of the body. In the digestive tract, a cecal swelling was noted at the junction that originates the single cecum. It was concluded that through confocal laser scanning microscopy, new interpretations of morphological structures of S. mansoni worms could be achieved, modifying adopted and current descriptions. The gonad consists of a single lobed testis, similar to that observed in some trematode species. Moreover, the same specimens can be observed either by BM or CLSM, considering that the latter causes only focal and limited damage in tissue structures.

Morphological aspects of Schistosoma mansoni adult worms isolated from nourished and undernourished mice: a comparative analysis by confocal laser scanning microscopy

Malnutrition hampers the course of schistosomiasis mansoni infection just as normal growth of adult worms. A comparative morphometric study on adult specimens (male and female) recovered from undernourished (fed with a low protein diet - regional basic diet) and nourished (rodent commercial laboratory food, NUVILAB) white mice was performed. Tomographic images and morphometric analysis of the oral and ventral suckers, reproductive system and tegument were obtained by means of confocal laser scanning microscopy. Undernourished male specimens presented smaller morphometric values (length and width) of the reproductive system (first, third and last testicular lobes) and thickness of the tegument than controls. Besides that, it was demonstrated that the dorsal surface of the male worms bears large tubercles unevenly distributed, but kept grouped and flat. At the subtegumental region, vacuolated areas were detected. It was concluded that the inadequate nutritional status of the vertebrate host has a negative influence mainly in the reproductive system and topographical somatic development of male adult Schistosoma mansoni, inducing some alterations on the structure of the parasite.

Reproductive system abnormalities in Schistosoma mansoni adult worms isolated from Nectomys squamipes (Muridae: Sigmodontinae): brightfield and confocal laser scanning microscopy analysis

Schistosoma mansoni adult worms with genital anomalies isolated from Nectomys squamipes (Muridae: Sigmodontinae) were studied by confocal laser scanning microscopy under the reflected mode. One male without testicular lobes (testicular agenesia/anorchism) and two females, one with an atrophied ovary and another with 17 uterine eggs, were identified. The absence of testicular lobes occurred in a worm presenting otherwise normal male adult characteristics: tegument, tubercles and a gynaecophoric canal with spines. In both female specimens the digestive tube showed a vacuolated appearance, and the specimen with supernumerary uterine eggs exhibited a developing miracidium and an egg with a formed shell. The area of the ventral sucker was similar in both specimens however the tegument thickness, ovary and vitelline glands of the specimen with the atrophied ovary were smaller than those of the one with supernumerary eggs. These reported anomalies in the reproductive system call attention to the need to improve our understanding of genetic regulation and the possible role of environmental influences upon trematode development.

Phenotypic plasticity in adult worms of Schistosoma mansoni (Trematoda:Schistosomatidae) evidenced by brightfield and confocal laser scanning microscopies

A comparative morphometric study was performed to identify host-induced morphological alterations in Schistosoma mansoni adult worms. A wild parasite population was obtained from a naturally infected rodent (Nectomys squamipes)and then recovered from laboratory infected C3H/He mice. Furthermore, allopatric worm populations maintained for long-term under laboratory conditions in Swiss Webster mice were passed on to N. squamipes. Suckers and genital system (testicular lobes, uterine egg, and egg spine) were analyzed by a digital system for image analysis. Confocal laser scanning microscopy (CLSM) showed details of the genital system (testicular lobes, vitelline glands, and ovary) and the tegument just below the ventral sucker. Significant morphological changes (p < 0.05) were detected in male worms in all experimental conditions, with no significant variability as assessed by CLSM. Significant changes (p < 0.05) were evident in females from the wild population related to their ovaries and vitelline glands, whereas allopatric females presented differences only in this last character. We conclude that S. mansoni worms present the phenotypic plasticity induced by modifications in the parasite's microenvironment, mainly during the first passage under laboratory conditions.

Laser therapy in pressure ulcers: evaluation by the Pressure Ulcer Scale for Healing and Nursing Outcomes Classification

AbstractOBJECTIVETo describe the pressure ulcer healing process in critically ill patients treated with conventional dressing therapy plus low-intensity laser therapy evaluated by the Pressure Ulcer Scale for Healing (PUSH) and the result of Wound Healing: Secondary Intention, according to the Nursing Outcomes Classification (NOC).METHODCase report study according to nursing process conducted with an Intensive Care Unit patient. Data were collected with an instrument containing the PUSH and the result of the NOC. In the analysis we used descriptive statistics, considering the scores obtained on the instrument.RESULTSA reduction in the size of lesions of 7cm to 1.5cm of length and 6cm to 1.1cm width, in addition to the increase of epithelial tissue and granulation, decreased secretion and odor.CONCLUSIONThere was improvement in the healing process of the lesion treated with adjuvant therapy and the use of NOC allowed a more detailed and accurate assessment than the PUSH.

Morfologia de agregados de Latossolos Bruno e Vermelho do estado do Paraná, avaliada por imagens obtidas em scanner

A forma e o tamanho das estruturas definem a maioria das características dos solos, principalmente a porosidade total e a distribuição dessa porosidade em macro e microporos. Objetivou-se neste trabalho o estudo da morfologia de diferentes classes de tamanho de agregados de duas toposseqüências de Latossolos (Latossolo Bruno distrófico húmico - LBd e Latossolo Vermelho distroférrico húmico - LVdf), ambos sob condições naturais e originados de rochas basálticas no Paraná, por meio de análise de imagens. Foram coletadas amostras indeformadas de dois horizontes (Bw1 e Bw2) nas toposseqüências do LBd (quatro perfis) e do LVdf (três perfis). Após secagem, as amostras foram separadas em seis classes de tamanho de agregados (2-4 mm;1-2 mm; 0,5-1 mm; 0,25-0,5 mm; 0,105-0,25 mm; e < 0,105 mm), determinando-se a distribuição percentual e o diâmetro médio geométrico (DMG). As imagens dos agregados das quatro maiores classes foram obtidas com scanner e processadas pelo programa de computador UTHSCSA Image Tool. Os agregados do LBd e do LVdf foram predominantemente poliedrais e rugosos, o que deve contribuir para aumentar a superfície externa destes. Os maiores valores de DMG, área e perímetro dos agregados foram verificados para o LBd, sobretudo para o horizonte mais profundo (Bw2). O grau de arredondamento aumentou com a diminuição da classe de tamanho dos agregados para ambos os solos, ou seja, agregados menores tendem a ser mais esféricos e menos rugosos. A qualidade da fração argila teve efeito não apenas no tamanho dos agregados, mas também na morfologia externa destes. Para algumas classes de tamanho de agregados dos horizontes do LBd e do LVdf, o aumento no DMG e na área, o crescimento preferencial em um eixo (alongamento) e a redução da rugosidade externa dos agregados foram favorecidos pelo maior teor de caulinita na fração argila. Efeito oposto foi verificado para os óxidos de Fe e Al.

Aggregation of subtropical soil under liming: a study using laser diffraction

Laser diffraction (LD) provides detailed analysis of particle size distribution. Its application to testing the stability of soil aggregates can assist studies on the aggregation of soils with contrasting electrochemical properties. The objectives of the present work were: (a) to propose a protocol for using LD to study soil aggregation, (b) to study the aggregation of an Acrisol under the influence of different doses and forms of lime. Samples were collected in 2005 from a Brazilian Acrisol that in 1994 had received 0.0; 2.0; 8.5 and 17.0 Mg ha-1 of lime, left on the soil surface or incorporated. Aggregates from 4.76 to 8.00 mm diameters were studied using the traditional method proposed by Kemper & Chepil (1965), with wet sieving, while aggregates from 1.00 to 2.00 mm were studied using a CILAS® laser diffractometer that distinguishes particles ranging from 0.04 to 2,500.00 μm. LD readings were made after six consecutive pre-treatments, using agitation times, a chemical dispersion agent and ultrasound. Mean Weighted Diameter (MWD) and the Aggregate Stability Index (ASI) calculated, using the traditional method does not discriminate the treatments. However, LD is able to produce detailed data on soil aggregation, resulting in indexes of stability of aggregates that are linearly related to the doses of lime applied (MWD: R² = 0.986 and ASI: R² = 0.876). It may be concluded that electrochemical changes in the Brazilian Acrisol resulting from incorporated lime affect the stability of aggregates, increasing stability with increased doses of lime.

Relations between soil surface roughness, tortuosity, tillage treatments, rainfall intensity and soil and water losses from a red yellow latosol

The soil surface roughness increases water retention and infiltration, reduces the runoff volume and speed and influences soil losses by water erosion. Similarly to other parameters, soil roughness is affected by the tillage system and rainfall volume. Based on these assumptions, the main purpose of this study was to evaluate the effect of tillage treatments on soil surface roughness (RR) and tortuosity (T) and to investigate the relationship with soil and water losses in a series of simulated rainfall events. The field study was carried out at the experimental station of EMBRAPA Southeastern Cattle Research Center in São Carlos (Fazenda Canchim), in São Paulo State, Brazil. Experimental plots of 33 m² were treated with two tillage practices in three replications, consisting of: untilled (no-tillage) soil (NTS) and conventionally tilled (plowing plus double disking) soil (CTS). Three successive simulated rain tests were applied in 24 h intervals. The three tests consisted of a first rain of 30 mm/h, a second of 30 mm/h and a third rain of 70 mm/h. Immediately after tilling and each rain simulation test, the surface roughness was measured, using a laser profile meter. The tillage treatments induced significant changes in soil surface roughness and tortuosity, demonstrating the importance of the tillage system for the physical surface conditions, favoring water retention and infiltration in the soil. The increase in surface roughness by the tillage treatments was considerably greater than its reduction by rain action. The surface roughness and tortuosity had more influence on the soil volume lost by surface runoff than in the conventional treatment. Possibly, other variables influenced soil and water losses from the no-tillage treatments, e.g., soil type, declivity, slope length, among others not analyzed in this study.

Reconstrução de maquetes 3D e manipulação da arquitetura de espécies perenes cultivadas no Brasil

Este trabalho teve como objetivo indicar algumas possíveis manipulações ecofisiológicas, com base em experimentos de arquitetura de plantas. Plantas de erva-mate, seringueira e videira foram caracterizadas no campo e no laboratório, e suas maquetes 3D foram reconstruídas com os programas V-Plants e PlantGLViewer. Indicações sobre a análise de crescimento e impactos ambientais, com a aplicação de diversas simulações, foram discutidas.