Aerobic Training after Myocardial Infarction: Remodeling Evaluated by Cardiac Magnetic Resonance

Abstract Background: Numerous studies show the benefits of exercise training after myocardial infarction (MI). Nevertheless, the effects on function and remodeling are still controversial. Objectives: To evaluate, in patients after (MI), the effects of aerobic exercise of moderate intensity on ventricular remodeling by cardiac magnetic resonance imaging (CMR). Methods: 26 male patients, 52.9 ± 7.9 years, after a first MI, were assigned to groups: trained group (TG), 18; and control group (CG), 8. The TG performed supervised aerobic exercise on treadmill twice a week, and unsupervised sessions on 2 additional days per week, for at least 3 months. Laboratory tests, anthropometric measurements, resting heart rate (HR), exercise test, and CMR were conducted at baseline and follow-up. Results: The TG showed a 10.8% reduction in fasting blood glucose (p = 0.01), and a 7.3-bpm reduction in resting HR in both sitting and supine positions (p < 0.0001). There was an increase in oxygen uptake only in the TG (35.4 ± 8.1 to 49.1 ± 9.6 mL/kg/min, p < 0.0001). There was a statistically significant decrease in the TG left ventricular mass (LVmass) (128.7 ± 38.9 to 117.2 ± 27.2 g, p = 0.0032). There were no statistically significant changes in the values of left ventricular end-diastolic volume (LVEDV) and ejection fraction in the groups. The LVmass/EDV ratio demonstrated a statistically significant positive remodeling in the TG (p = 0.015). Conclusions: Aerobic exercise of moderate intensity improved physical capacity and other cardiovascular variables. A positive remodeling was identified in the TG, where a left ventricular diastolic dimension increase was associated with LVmass reduction.

Disagreement between ultrasound and magnetic resonance imaging in the identification of schistosomal periportal fibrosis

Abdominal ultrasound (US) has been widely used in the evaluation of patients with schistosomiasis mansoni. It represents an important indirect method of diagnosis and classification of the disease, and it has also been used as a tool in the evaluation of therapeutic response and regression of fibrosis. We describe the case of a man in whom US showed solid evidence of schistosomal periportal fibrosis and magnetic resonance imaging revealed that periportal signal alteration corresponded to adipose tissue which entered the liver togheter with the portal vein.

Schistosoma mansoni: magnetic resonance analysis of liver fibrosis according to WHO patterns for ultrasound assessment of schistosomiasis-related morbidity

For the last two decades, ultrasound (US) has been considered a surrogate for the gold standard in the evaluation of liver fibrosis in schistosomiasis. The use of magnetic resonance imaging (MRI) is not yet standardised for diagnosing and grading liver schistosomal fibrosis. The aim of this paper was to analyse MRI using an adaptation of World Health Organization (WHO) patterns for US assessment of schistosomiasis-related morbidity. US and MRI were independently performed in 60 patients (42.1 ± 13.4 years old), including 37 men and 23 women with schistosomiasis. Liver involvement appraised by US and MRI was classified according to the WHO protocol from patterns A-F. Agreement between image methods was evaluated by kappa index (k). The correlation between US and MRI was poor using WHO patterns [k = 0.14; confidence interval (CI) 0.02; 0.26]. Even after grouping image patterns as "A-D", "Dc-E" and "Ec-F", the correlation between US and MRI remained weak (k = 0.39; CI 0.21; 0.58). The magnetic resonance adaptation used in our study did not confirm US classification of WHO patterns for liver fibrosis.

Nitrogen dynamics in soil management systems. I - flux of inorganic nitrogen (NH4+ and NO3-)

In agricultural systems the N-NH4+ and N-NO3- contents is significantly affected by soil management. This study investigated the dynamics of inorganic nitrogen (N; NH4+ and NO3-) in an experimental evaluation of soil management systems (SMSs) adopted in 1988 at the experimental station of the ABC Foundation in Ponta Grossa, in the Central South region of the State of Paraná. The objective of this study was to evaluate the changes in N-NH4+ and N-NO3- flux in the surface layer of a Red Latosol arising from SMSs over a 12-month period. The experiment was arranged in a completely randomized block design in split plots, in three replications. The plots consisted of the following SMSs: 1) conventional tillage (CT); 2) minimum tillage (MT); 3) no-tillage with chisel plow every three years (NT CH); and 4) continuous no-tillage (CNT). To evaluate the dynamics of inorganic N, the subplots represented samplings (11 sampling times, T1 - T11). The ammonium N (N-NH4+) and nitric N (N-NO3-) contents were higher in systems with reduced tillage (MT and NT CH) and without tillage (CNT) than in the CT system. In the period from October 2003 to February 2004, the N-NH4+ was higher than the N-NO3- soil content. Conversely, in the period from May 2004 to July 2004, the N-NO3- was higher than the N-NH4+ content. The greatest fluctuation in the N-NH4+ and N-NO3- contents occurred in the 0-2.5 cm layer, and the highest peak in the N-NH4+ and N-NO3- concentrations occurred after the surface application of N. Both N-NH4+ and N-NO3- were strongly correlated with the soil organic C content, which indicated that these properties vary together in the system.

Soil CO2 flux: a method comparison of closed static chambers in a sugarcane field

A large variety of techniques have been used to measure soil CO2 released from the soil surface, and much of the variability observed between locations must be attributed to the different methods used by the investigators. Therefore, a minimum protocol of measurement procedures should be established. The objectives of this study were (a) to compare different absorption areas, concentrations and volumes of the alkali trapping solution used in closed static chambers (CSC), and (b) to compare both, the optimized alkali trapping solution and the soda-lime trapping using CSC to measure soil respiration in sugarcane areas. Three CO2 absorption areas were evaluated (7; 15 and 20 % of the soil emission area or chamber); two volumes of NaOH (40 and 80 mL) at three concentrations (0.1, 0.25 and 0.5 mol L-1). Three different types of alkaline traps were tested: (a), 80 mL of 0.5 mol L-1 NaOH in glass containers, absorption area 15 % (V0.5); (b) 40 mL of 2 mol L-1 NaOH retained in a sponge, absorption area 80 % (S2) and (c) 40 g soda lime, absorption area 15 % (SL). NaOH concentrations of 0.5 mol L-1 or lower underestimated the soil CO2-C flux or CO2 flux. The lower limit of the alkali trap absorption area should be a minimum of 20 % of the area covered by the chamber. The 2 mol L-1 NaOH solution trap (S2) was the most efficient (highest accuracy and highest CO2 fluxes) in measuring soil respiration.

Magnetic susceptibility to identify landscape segments on a detailed scale in the region of Jaboticabal, São Paulo, Brazil

The agricultural potential is generally assessed and managed based on a one-dimensional vision of the soil profile, however, the increased appreciation of sustainable production has stimulated studies on faster and more accurate evaluation techniques and methods of the agricultural potential on detailed scales. The objective of this study was to investigate the possibility of using soil magnetic susceptibility for the identification of landscape segments on a detailed scale in the region of Jaboticabal, São Paulo State. The studied area has two slope curvatures: linear and concave, subdivided into three landscape segments: upper slope (US, concave), middle slope (MS, linear) and lower slope (LS, linear). In each of these segments, 20 points were randomly sampled from a database with 207 samples forming a regular grid installed in each landscape segment. The soil physical and chemical properties, CO2 emissions (FCO2) and magnetic susceptibility (MS) of the samples were evaluated represented by: magnetic susceptibility of air-dried fine earth (MS ADFE), magnetic susceptibility of the total sand fraction (MS TS) and magnetic susceptibility of the clay fraction (MS Cl) in the 0.00 - 0.15 m layer. The principal component analysis showed that MS is an important property that can be used to identify landscape segments, because the correlation of this property within the first principal component was high. The hierarchical cluster analysis method identified two groups based on the variables selected by principal component analysis; of the six selected variables, three were related to magnetic susceptibility. The landscape segments were differentiated similarly by the principal component analysis and by the cluster analysis using only the properties with higher discriminatory power. The cluster analysis of MS ADFE, MS TS and MS Cl allowed the formation of three groups that agree with the segment division established in the field. The grouping by cluster analysis indicated MS as a tool that could facilitate the identification of landscape segments and enable the mapping of more homogeneous areas at similar locations.

Contribution of macroporosity to water flux of a soil under different tillage systems

In view of the importance of the macroporosity for the water transport properties of soils, its quantitative assessment is a challenging task. Measurements of hydraulic conductivity (K) at different soil water tensions and the quantification of water-conducting macropores (θM) of a soil under different tillage systems could help understand the effects on the soil porous system and related hydraulic properties. The purpose of this study was to assess the effects of Conventional Tillage (CT), Chisel Plow (CP) and No Tillage (NT) on θM and on K; and to quantify the contribution of macroporosity to total water flux in a loam soil. A tension disc infiltrometer was used at two soil water pressure heads (-5 cm, and 0) to infer θM and K, during fallow. Macroporosity was determined based on the flow contribution between 0 and -5 cm water potentials (K0, K5, respectively), according to the Hagen-Poiseuille equation. The K0 values were statistically higher for CT than for NT and CP. The K5 values did not differ statistically among treatments. The mean K values varied between 0.20 and 3.70 cm/h. For CT, θM was significantly greater than for CP and NT, following the same trend as K0. No differences in θM were detected between CP and NT. With CT, the formation of water-conducting macropores with persistence until post-harvest was possible, while under CP preparation, the water-conducting macropores were not persistent. These results support the idea that tillage affects the soil water movement mainly by the resulting water-conducting macropores. Future studies on tillage effects on water movement should focus on macroporosity.

Structural and magnetic characterization of maghemites prepared from Al-substituted magnetites

Synthetic aluminum-substituted maghemites were characterized by total chemical analysis, powder X-ray diffraction (XRD), Mössbauer spectroscopy (ME), and vibrating sample magnetometry (VSM). The aim was to determine the structural, magnetic, and hyperfine properties of γ-Fe2-xAl xO3 as the Al concentration is varied. The XRD results of the synthetic products were indexed exclusively as maghemite. Increasing Al for Fe substitution decreased the mean crystalline dimension and shifted all diffraction peaks to higher º2θ angles. The a0 dimension of the cubic unit cell decreased with increasing Al according to the equation a o = 0.8385 - 3.63 x 10-5 Al (R²= 0.94). Most Mössbauer spectra were composed of one sextet, but at the highest substitution rate of 142.5 mmol mol-1 Al, both a doublet and sextet were obtained at 300 K. All hyperfine parameters from the sub-spectra were consistent with high-spin Fe3+ (0.2 a 0.7 mms-1) and suggested a strong superparamagnetic component associated with the doublet. The magnetic hyperfine field of the sextets decreased with the amount of Al-substitution [Bhf (T) = 49.751 - 0.1202Al; R² = 0.94] while the linewidth increased linearly. The saturation magnetization also decreased with increasing isomorphous substitution.

Phosphorus analysis in soil under herbaceous perennial leguminous cover by nuclear magnetic spectroscopy

The availability and the reserves of organic phosphorus are controlled by its mineralization rate and are also influenced by changes in soil management. The objective of this study was to evaluate the influence of soil covering with different leguminous plant on soil organic P by 31P-NMR spectroscopy. Alkaline soil extracts were obtained from two depths (0-5 and 5-10 cm) of an Ultisol cultivated with herbaceous perennial leguminous plants (Arachis pintoi, Pueraria phaseoloides, Macroptilium atropurpureum). In an adjacent area, samples of the same soil cover with a secondary tropical forest and grass (Panicum maximum) were also collected. The leguminous management was divided into with removal and without removal of shoot parts after cut on soil surface. Phosphate monoesters are the dominant P species in all soil samples and P diesters accumulated on the superficial layer of secondary forest soil. The P amount of this fraction is higher for the legume covered soil when compared with the grass covered soil. The permanence of leguminous plants on the topsoil after the cut promoted an increase in P diester/P monoester ratios. These findings can be accounted for an enhancement of P availability to plants in soils cultivated with leguminous plants.

Trapped periosteum in a distal femoral physeal injury: magnetic resonance imaging evaluation

Epiphyseal fractures are frequently associated with knee trauma during sports in children and adolescents. Usually, Salter-Harris types I and II fractures are conservatively treated. However, failed closed reduction of displaced fractures suggest the presence of trapped periosteum, with indication for surgery. The present report describes a case of Salter-Harris type I fracture of the distal femur in a child, complicated with trapped periosteum detected at magnetic resonance imaging.

Magnetic resonance imaging findings of disc-related epidural cysts in nonsurgical and postoperative microdiscectomy patients

OBJECTIVE: To demonstrate five discal cysts with detailed magnetic resonance imaging findings in nonsurgical and following postoperative microdiscectomy. MATERIALS AND METHODS: Five discal cysts in four patients who underwent magnetic resonance imaging were found through a search in our database and referral from a single orthopedic spine surgeon. Computed tomography in two cases and computed tomography discography in one case were also performed. RESULTS: Five discal cysts were present in four patients. Three patients had no history of previous lumbar surgery and the other patient presented with two discal cysts and recurrent symptoms after partial laminectomy and microdiscectomy. All were oval shaped and seated in the anterior epidural space. Four were ventrolateral, and the other one was centrally positioned in the anterior spinal canal. One showed continuity with the central disc following discography. Three were surgically removed. CONCLUSION: Magnetic resonance imaging can easily depict an epidural cyst and the diagnosis of a discal cyst should be raised when an homogeneous ventrolateral epidural cyst contiguous to a mild degenerated disc is identified.

Incidental enchondromas at knee magnetic resonance imaging: intraobserver and interobserver agreement and prevalence of imaging findings

Objective To evaluate intra- and interobserver agreement in the identification of incidental enchondromas at knee magnetic resonance imaging, and to assess the prevalence of imaging findings. Materials and Methods Retrospective study reviewing 326 knee magnetic resonance images acquired in the period between November 2009 and September 2010. The images were independently and blindly analyzed by two specialists in musculoskeletal radiology, with the objective of identifying incidental enchondromas, presence of foci with signal similar to bone marrow and foci of signal absence suggestive of calcifications within the enchondromas. Inter- and intraobserver agreements were analyzed. Results Eleven lesions compatible with enchondromas (3.3%) were identified. The interobserver agreement for the presence of enchondroma was high. Prevalence of foci of bone marrow signal inside the enchondromas was of 54.55%, and foci suggestive of calcification corresponded to 36.36%. The intraobserver agreement for foci of bone marrow signal in enchondromas was perfect, and interobserver agreement was high. Conclusion The prevalence of incidental enchondromas in the current study was compatible with data in the literature. Excellent agreement was observed in the identification of enchondromas and in the assessment of imaging findings. A higher prevalence of fat signal foci was observed as compared with signal absence suggestive of calcifications.

Pyogenic and tuberculous discitis: magnetic resonance imaging findings for differential diagnosis

Spondylodiscitis represents 2%–4% of all bone infections cases. The correct diagnosis and appropriate treatment can prevent complications such as vertebral collapse and spinal cord compression, avoiding surgical procedures. The diagnosis is based on characteristic clinical and radiographic findings and confirmed by blood culture and biopsy of the disc or the vertebra. The present study was developed with Clementino Fraga Filho University Hospital patients with histopathologically and microbiologically confirmed diagnosis of spondylodiscitis, submitted to magnetic resonance imaging of the affected regions. In most cases, pyogenic spondylodiscitis affects the lumbar spine. The following findings are suggestive of the diagnosis: segmental involvement; ill-defined abscesses; early intervertebral disc involvement; homogeneous vertebral bodies and intervertebral discs involvement. Tuberculous spondylodiscitis affects preferentially the thoracic spine. Most suggestive signs include: presence of well-defined and thin-walled abscess; multisegmental, subligamentous involvement; heterogeneous involvement of vertebral bodies; and relative sparing of intervertebral discs. The present pictorial essay is aimed at showing the main magnetic resonance imaging findings of pyogenic and tuberculous discitis.

Diffusion-weighted magnetic resonance imaging: biomarker for treatment response in oncology

The authors report a case where a quantitative assessment of the apparent diffusion coefficient (ADC) of liver metastasis in a patient undergoing chemotherapy has shown to be an effective early marker for predicting therapeutic response, anticipating changes in tumor size. A lesion with lower initial ADC value and early increase in such value in the course of the treatment tends to present a better therapeutic response.