Primary coronary angioplasty in a nonagenarian

A woman aged 98 years entered the tertiary hospital service with a picture of acute myocardial infarction of the extensive anterior wall, which began 4 hours earlier. Due to the large myocardial risk area suggested by the electrocardiogram, the patient was taken to the hemodynamics laboratory for the performance of emergency coronary arteriography, which revealed occlusion in the proximal third of the anterior descending artery. Primary angioplasty followed by stent grafting was successfully performed. The patient had a satisfactory evolution (Killip I) and was discharged from the hospital on the seventh postinfarction day. We discuss here aspects of thrombolysis and coronary percutaneous interventions in the aged.

Internal Mammary to Pulmonary Artery Fistula Presenting as Early Recurrent Angina after Coronary Bypass

A 50-year-old man developed recurrent angina 1 year after coronary artery bypass surgery. The patient was found to have a large fistula involving branches of the internal mammary artery graft and the left pulmonary artery. In the absence of another clear cause for the patient's symptoms, we speculated that our patient's angina and abnormal stress nuclear study were due to coronary steal. In patients with a history of coronary bypass grafting, fistula formation between graft and native vessels should be considered as a possible cause of early recurrent angina.

Applicability of Two International Risk Scores in Cardiac Surgery in a Reference Center in Brazil

Background:The applicability of international risk scores in heart surgery (HS) is not well defined in centers outside of North America and Europe.Objective:To evaluate the capacity of the Parsonnet Bernstein 2000 (BP) and EuroSCORE (ES) in predicting in-hospital mortality (IHM) in patients undergoing HS at a reference hospital in Brazil and to identify risk predictors (RP).Methods:Retrospective cohort study of 1,065 patients, with 60.3% patients underwent coronary artery bypass grafting (CABG), 32.7%, valve surgery and 7.0%, CABG combined with valve surgery. Additive and logistic scores models, the area under the ROC (Receiver Operating Characteristic) curve (AUC) and the standardized mortality ratio (SMR) were calculated. Multivariate logistic regression was performed to identify the RP.Results:Overall mortality was 7.8%. The baseline characteristics of the patients were significantly different in relation to BP and ES. AUCs of the logistic and additive BP were 0.72 (95% CI, from 0.66 to 0.78 p = 0.74), and of ES they were 0.73 (95% CI; 0.67 to 0.79 p = 0.80). The calculation of the SMR in BP was 1.59 (95% CI; 1.27 to 1.99) and in ES, 1.43 (95% CI; 1.14 to 1.79). Seven RP of IHM were identified: age, serum creatinine > 2.26 mg/dL, active endocarditis, systolic pulmonary arterial pressure > 60 mmHg, one or more previous HS, CABG combined with valve surgery and diabetes mellitus.Conclusion:Local scores, based on the real situation of local populations, must be developed for better assessment of risk in cardiac surgery.

Debranching Solutions in Endografting for Complex Thoracic Aortic Dissections

Background: Conventional surgical repair of thoracic aortic dissections is a challenge due to mortality and morbidity risks. Objectives: We analyzed our experience in hybrid aortic arch repair for complex dissections of the aortic arch. Methods: Between 2009 and 2013, 18 patients (the mean age of 67 ± 8 years-old) underwent hybrid aortic arch repair. The procedural strategy was determined on the individual patient. Results: Thirteen patients had type I repair using trifurcation and another patient with bifurcation graft. Two patients had type II repair with replacement of the ascending aorta. Two patients received extra-anatomic bypass grafting to left carotid artery allowing covering of zone 1. Stent graft deployment rate was 100%. No patients experienced stroke. One patient with total debranching of the aortic arch following an acute dissection of the proximal arch expired 3 months after TEVAR due to heart failure. There were no early to midterm endoleaks. The median follow-up was 20 ± 8 months with patency rate of 100%. Conclusion: Various debranching solutions for different complex scenarios of the aortic arch serve as less invasive procedures than conventional open surgery enabling safe and effective treatment of this highly selected subgroup of patients with complex aortic pathologies.

Plant availability of trace elements in sewage sludge-treated soils: methodology¹

Synthetic root exudates were formulated based on the organic acid composition of root exudates derived from the rhizosphere of aseptically grown corn plants, pH of the rhizosphere, and the background chemical matrices of the soil solutions. The synthetic root exudates, which mimic the chemical conditions of the rhizosphere environment where soil-borne metals are dissolved and absorbed by plants, were used to extract metals from sewage-sludge treated soils 16 successive times. The concentrations of Zn, Cd, Ni, Cr, and Cu of the sludge-treated soil were 71.74, 0.21, 15.90, 58.12, and 37.44 mg kg-1, respectively. The composition of synthetic root exudates consisted of acetic, butyric, glutaric, lactic, maleic, propionic, pyruvic, succinic, tartaric, and valeric acids. The organic acid mixtures had concentrations of 0.05 and 0.1 mol L-1 -COOH. The trace elements removed by successive extractions may be considered representative for the availability of these metals to plants in these soils. The chemical speciation of the metals in the liquid phase was calculated; results showed that metals in sludge-treated soils were dissolved and formed soluble complexes with the different organic acid-based root exudates. The most reactive organic acid ligands were lactate, maleate, tartarate, and acetate. The inorganic ligands of chloride and sulfate played insignificant roles in metal dissolution. Except for Cd, free ions did not represent an important chemical species of the metals in the soil rhizosphere. As different metals formed soluble complexes with different ligands in the rhizosphere, no extractor, based on a single reagent would be able to recover all of the potentially plant-available metals from soils; the root exudate-derived organic acid mixtures tested in this study may be better suited to recover potentially plant-available metals from soils than the conventional extractors.

Grafted eggplant yield, quality and growth in infested soil with Verticillium dahliae and Meloidogyne incognita

The objective of this work was to evaluate the effect of grafting (onto Solanum torvum Sw.) on plant growth, yield and fruit quality of the Pala and Faselis eggplant (Solanum melongena L.) cultivars, grown in a soil infested with Verticillium dahliae Kleb. and Meloidogyne incognita, or in noninfested soil. Soil infestation decreased yield, plant height, final above-ground biomass, and also reduced fruit mean weight and shoot dry weight depending on cultivar or grafting. Grafting decreased fruit oxalic acid and the soluble solid contents, and increased mean fruit weight, depending on cultivar and soil infestation. Grafting also reduced the negative effects of the pathogens on disease index, plant height and shoot dry weight. Cultivar Pala was more vigorous than Faselis, and S. torvum was a vigorous rootstock. The combination of a vigorous rootstock with a weak cultivar (Faselis) is more profitable than that of a vigorous rootstock and a vigorous cultivar (Pala). Using S. torvum as a rootstock for cultivar Faselis, grown in soil infested with the pathogens, is most likely to be useful in conventional and low-input sustainable horticulture, since grafting increases protection against the pathogens, and reduces the losses in quality and yield.

Leaf mineral composition of grafted eggplant grown in soil infested with Verticillium and root-knot nematodes

The objective of this work was to determine differences in leaf mineral composition between ungrafted and grafted onto (Solanum torvum) eggplant (Solanum melongena), cultivars 'Faselis' and 'Pala', grown in a soil infested with Verticillium dahliae and Meloidogyne incognita, or in a noninfested soil. Grafting increased leaf P and Mn concentrations, and decreased N concentrations, in both soils. Grafting also enhanced leaf Ca concentration of 'Pala', but it did not affect that of 'Faselis' depending on the cropping year. Leaf Mg concentration of grafted plants in infested soil was lower than that of ungrafted ones in noninfested soil. Results showed that, under the same fertilization program, the grafted 'Faselis' plants used the nutrients more efficiently than the 'Pala' ones. Use of S. torvum as a rootstock for 'Faselis' resulted in an effective protection against multiple pathogen infestation. Fertilization may be necessary when grafted 'Faselis' plants are grown in a soil infested with the pathogens, since grafting and infestation generally decrease leaf N, Mg, Ca and Fe concentrations, either by reducing the nutrient concentrations directly or by increasing leaf Mn concentration.

Reaction of sweet orange cultivars expressing the attacin A gene to 'Candidatus Liberibacter asiaticus' infection

The objective of this work was to evaluate the reaction of four sweet orange cultivars expressing the attacin A gene to 'Candidatus Liberibacter asiaticus' (Las) infection, a bacterium associated to huanglongbing (HLB) disease. Transgenic sweet orange plants of Hamlin, Natal, Pêra, and Valência cultivars, as well as nontransgenic controls received inocula by grafting budwood sections of HLB-infected branches. Disease progression was evaluated through observations of leaf symptoms and by polymerase chain reaction (PCR) analysis, eight months after inoculation. A completely randomized design was used, with four experiments (one for each cultivar) performed simultaneously. Bacteria title was estimated by quantitative PCR (qPCR). HLB symptoms and Las titers were present in nontransgenic and transgenic plants expressing the attacin A gene of the four sweet orange cultivars, eight months after bacteria inoculation. Five transgenic lines (transformation events) of 'Pêra' sweet orange expressing the attacin A gene have significantly lower Las titers in comparison with nontransgenic plants of this cultivar.

Effect of temperature on percentage of germination of canistel seeds (Pouteria campechiana)

The canistel is a fruit originated in Mexico and Central America, being introduced in Brazil in 1986. The plants present medium size, however it can reach up to 15 meters of height; the leaves measure about 10 to 25 cm; the flowers are complete and small and the fruit presents yellow coloration when ripe, with whitish pulp and sweet flavor. The propagation can be realized by seed or grafting. In view of almost total absence of information about the culture and the possibility to have a commercial cultivation, the present work, was live in which the effect of the temperature was evaluated in the percentage of germination of the seeds. It was checked that the best averages were obtained in temperature of 30ºC and the minor in 15ºC, 20ºC and 40ºC could be considerate the worst of them.

Identification of plantlet genetic origin in polyembryonic mango (Mangifera indica, L.) cv. Rosinha seeds using RAPD markers

Mango can be propagated by seeds or by grafting. For commercial purpose, grafting is the most appropriate method because it maintains the genetic characters from the propagated variety. To obtain grafted mango it is important to use polyembryonic varieties as rootstock since they produce a zygotic and many nucellar plantlets. The nucellar plantlets maintain the genetics of the mother-plant thus, are preferred for grafting since they supposedly give more uniformity to the orchard. In general, nurserymen use the most vigorous plantelet to graft, believing that they are nucellar. But, orchard disuniformities on height and yield are very common among mango trees of commercial orchards in Northeast region. The objective of this paper was to identify the genetical origin of plantlets from polyembryonic seeds of Rosinha variety using Random Amplified Polymorphic DNA (RAPD) markers. Moreover, the position of the zygotic embryo and the percentage of the vigorous zygotic and nucellar plantlets was also determined. It was obtained an elevated taxa of vigorous zygotic plantlets which possibly explains the disuniformity on height of trees at commercial mango orchards.

Monitoring the viability of citrus rootstocks seeds stored under refrigeration

The citrus nursery tree is produced through the bud grafting process, in which rootstock is usually grown from seed germination. The objective of this research was to evaluate, in two dissimilar environmental conditions, the viability and polyembryony expression of five citrus rootstocks seeds stored in different periods under refrigeration. The rootstock varieties evaluated were: Rangpur lime (Citrus limonia Osb. cv. Limeira), Trifoliate orange (Poncirus trifoliata Raf. cv. Limeira), Citrumelo (P. trifoliata x C. paradisi Macf. cv. Swingle), Sunki mandarin (C. sunki Hort. ex Tanaka) and Volkamer lemon (C. volkameriana Ten. & Pasq. cv. Catania 2). The experimental design was the randomized blocks in a 11 x 5 x 2 factorial scheme, evaluating from time zero to the tenth month of storage, the five varieties of rootstock in two environments: germination and growth B.O.D type chamber (Biological Oxygen Demand - Eletrolab Brand Model FC 122) at 25 °C; and greenhouse seedbed with partial temperature control (22 °C to 36 °C) and humidity control (75-85%). The plot had 24 seeds in four replicates, using trays with substrate in greenhouse and Petri dishes with filter paper in B.O.D. chamber. The seed germination rate and polyembryony expression were evaluated monthly. It was concluded that Trifoliate and Citrumelo Swingle seeds can be stored for up to seven months, while Volkamer lemon, Rangpur lime and Sunki seeds can be stored for up to ten months. The polyembryony expression rate was slightly higher when measured in greenhouse than in B.O.D. chamber and remained stable in both environments until the seventh month, from which dropped sharply. Citrumelo Swingle seeds expressed the highest polyembryony rate (18.8%), followed by Rangpur lime and Volkamer lemon (average value of 13.7%), Sunki (9.4%) and Trifoliate (3.2%). Despite some differences among varieties, the viability of rootstock stored seeds can be monitored either in the greenhouse or in B.O.D. germination chamber, the latter being the faster and more suitable method.

Topworking of 'Bengal' lychee trees in the state of São Paulo, Brazil

This study aimed to evaluate the performance of 'Feizixiao', 'Nuomici', 'Heiye', 'Kway May Pink' and 'Bengal' lychee cultivars topworked onto bearing 'Bengal' trees. The experiments were carried out in commercial orchard at Rio das Pedras Farm in Jundiaí, state of São Paulo. The experimental design consisted of randomized blocks in a subdivided parcel arrangement, in which the parcel consisted of five cultivars and the sub-parcel consisted of six evaluation periods. Five replicates of three plants per parcel and six grafts per plant, (with two grafts per main branch) were used. The trees were approximately 10 years old propagated by air layering and planted with 6 x 4 m (416 plants/ha) spacing. The following characteristics were evaluated: success rate of the grafts, number of shoots, shoot length, number of nodes, number of leaves and chlorophyll content (SPAD). The control ('Bengal'/'Bengal') had the highest grafting success rate with 89.9%. On the other hand, 'Heiye', 'Feizixião', 'Nuomici' and 'Kway May Pink' had, respectively, 60.6, 55.0, 52.6 and 47.0% grafting success rates. All of the shoot grafts had normal growth with no signs of incompatibility. Therefore, the cultivars studied are compatible with 'Bengal' and may be used on commercial orchards.

Determinacion de la configuracion E-Z de los acidos Fumarico y Maleico. Un experimento orientado a incentivar el desarrollo de la investigacion cientifica en alumnos de Pregrado

In this work we intend to eliminate the idea that laboratory exercises seem like cookbooks. That is, exercises shall be presented as a problematic situation. Based on observation and experimentation, the students should determine the E-Z configuration of maleic and fumaric acids. The basis of this laboratory exercise is the acid-catalyzed isomerization of maleic acid to fumaric acid. Students are given the starting material, reagents and the experimental procedure. They are told that the starting material is a dicarboxylic acid containing a C=C double bond of formula C4H4O4. Students determine melting points, solubilities, acidity and chromatographic patterns for both the starting material and the product, so that a configuration of each acid can be proposed. This type of experiment yields excellent results, because the students are left to deduce that maleic acid is less stable than fumaric acid. Additionally, they conclude that maleic acid is the "Z" isomer and fumaric acid is the "E" isomer. Finally, this laboratory exercise allows the students to develop simultaneously their critical-thinking skills with the respective laboratory techniques and not to see chemistry as recipes to be followed.

Utilização de endoperóxidos de derivados de naftaleno como fontes químicas de oxigênio singlete em sistemas biológicos

Molecular oxygen, in the first excited state (singlet oxygen, ¹O2), has a substantial reactivity towards electron-rich organic molecules, such as biological targets, including unsaturated fatty acids, proteins, RNA and DNA. Considering the complexity of biological systems and the great variety of reactive species generated by photochemistry, efforts have been devoted to develop suitable ¹O2 generators based on the thermolysis of water soluble naphthalene endoperoxides. These compounds are chemically inert and have been employed as versatile sources of ¹O2. The synthesis is based on structural modifications in position 1,4 of dimethylnaphtalene, grafting hydrophilic substituents. The correspondent endoperoxide can be generated using photochemical method, or molybdate-catalyzed disproportionation of hydrogen peroxide.

Ligações hidrogênio fortes em ácidos dicarboxílicos e diaminas aromáticas

A very short-strong hydrogen bond (<2 Å, >20kcal/mol) is found in the monoanion of certain dicarboxylic acids derived from maleic and dialkylmalonic acids. Certain aromatic diamines that are known as proton sponge have exceptionally high basicity (pKa) and are only monoprotonated with strong acids like percloric acid. The closed proximity between the two basic centers provokes a strong steric interaction that is relieved upon protonation. Similar effects are found in dicarboxylic acids (hydrogen maleate and hydrogen dialkylmalonates) that present a very short distance between the two oxygens and a short-strong hydrogen bond.