Revisão ética e termo de consentimento livre e esclarecido nas publicações de pesquisas cardiovasculares na Argentina

FUNDAMENTO: Existem evidências de que algumas vezes os requisitos de aprovação do Conselho de Revisão Institucional (IRB) e obtenção de termo de consentimento livre e esclarecido (TCLE) para a realização de pesquisas com seres humanos não são cumpridos nas publicações argentinas de pesquisas cardiovasculares. OBJETIVO: Analisar a freqüência com que a aprovação do IRB e o TCLE são obtidos na Argentina. MÉTODOS: Pedimos que cem autores de artigos apresentados no nosso encontro científico de 2006 respondessem a um questionário. RESULTADOS: Trinta e seis por cento dos questionários foram devolvidos com confirmação de revisão ética, 34% responderam que não havia sido feita, 23% disseram que tinham sido isentados da revisão e 7% não foram devolvidos. A maioria dos artigos submetidos à revisão era de estudos farmacológicos ou pesquisas sobre avaliação de novos dispositivos. A maioria dos artigos que não passaram por revisão ética era referente a pesquisas epidemiológicas ou estudos para avaliação de métodos não-invasivos; 60% dos estudos farmacológicos, implante celular ou avaliação de novos dispositivos atendiam às exigências das normas federais. CONCLUSÃO: A taxa de revisão ética e a obtenção do TCLE nas publicações argentinas de pesquisas cardiovasculares varia entre os artigos. A maior parte das pesquisas referentes a estudos observacionais prospectivos e cerca de 50% dos protocolos de intervenções ou procedimentos invasivos não relatam a realização de revisão ética. Essa porcentagem elevada de artigos que não são submetidos à revisão ética indica a existência de falhas legais e éticas que devem ser discutidas e corrigidas.

I diretriz de ressuscitação cardiopulmonar e cuidados cardiovasculares de emergência da Sociedade Brasileira de Cardiologia: resumo executivo

Apesar de avanços nos últimos anos relacionados à prevenção e a tratamento, muitas são as vidas perdidas anualmente no Brasil relacionado à parada cardíaca e a eventos cardiovasculares em geral. O Suporte Básico de Vida envolve o atendimento às emergências cardiovasculares principalmente em ambiente pré-hospitalar, enfatizando reconhecimento e realização precoces das manobras de ressuscitação cardiopulmonar com foco na realização de compressões torácicas de boa qualidade, assim como na rápida desfibrilação, por meio da implementação dos programas de acesso público à desfibrilação. Esses aspectos são de fundamental importância e podem fazer diferença no desfecho dos casos como sobrevida hospitalar sem sequelas neurológicas. O início precoce do Suporte Avançado de Vida em Cardiologia também possui papel essencial, mantendo, durante todo o atendimento, a qualidade das compressões torácicas, adequado manejo da via aérea, tratamento específico dos diferentes ritmos de parada, desfibrilação, avaliação e tratamento das possíveis causas. Mais recentemente dá-se ênfase a cuidados pós-ressuscitação, visando reduzir a mortalidade por meio do reconhecimento precoce e tratamento da síndrome pós-parada cardíaca. A hipotermia terapêutica tem demonstrado melhora significativa da lesão neurológica e deve ser realizada em indivíduos comatosos pós-parada cardíaca. Para os médicos que trabalham na emergência ou unidade de terapia intensiva é de grande importância o aperfeiçoamento no tratamento desses pacientes por meio de treinamentos específicos, possibilitando maiores chances de sucesso e maior sobrevida.

Association between LDL-C, Non HDL-C, and Apolipoprotein B Levels with Coronary Plaque Regression

Background:Previous reports have inferred a linear relationship between LDL-C and changes in coronary plaque volume (CPV) measured by intravascular ultrasound. However, these publications included a small number of studies and did not explore other lipid markers.Objective:To assess the association between changes in lipid markers and regression of CPV using published data.Methods:We collected data from the control, placebo and intervention arms in studies that compared the effect of lipidlowering treatments on CPV, and from the placebo and control arms in studies that tested drugs that did not affect lipids. Baseline and final measurements of plaque volume, expressed in mm3, were extracted and the percentage changes after the interventions were calculated. Performing three linear regression analyses, we assessed the relationship between percentage and absolute changes in lipid markers and percentage variations in CPV.Results:Twenty-seven studies were selected. Correlations between percentage changes in LDL-C, non-HDL-C, and apolipoprotein B (ApoB) and percentage changes in CPV were moderate (r = 0.48, r = 0.47, and r = 0.44, respectively). Correlations between absolute differences in LDL-C, non‑HDL-C, and ApoB with percentage differences in CPV were stronger (r = 0.57, r = 0.52, and r = 0.79). The linear regression model showed a statistically significant association between a reduction in lipid markers and regression of plaque volume.Conclusion:A significant association between changes in different atherogenic particles and regression of CPV was observed. The absolute reduction in ApoB showed the strongest correlation with coronary plaque regression.

Effects of anthropogenic impacts on benthic macroinvertebrates assemblages in subtropical mountain streams

The nature of the riparian and surrounding landscape has been modified by anthropogenic activities, which may subsequently alter the composition and functional structure of macroinvertebrate assemblages. The effect of these changes on function of benthic fauna is difficult to assess due to the scarce knowledge on functional structures in tropical streams. In this study we evaluate whether sites impacted and unimpacted by anthropogenic alterations differed in assemblage composition and density, richness and diversity of each functional feeding group. The selection of the sites was related to their distinct riparian characteristics, following the QBRy riparian quality index. Collector-gatherer was the dominant functional feeding group, comprising 91% of total density, whereas the proportion of shredders was very low, representing less of 0.5% of total density. Asemblage composition of macroinvertebrates differed between impacted and unimpacted sites. Predators were dominant in taxa number, representing about 60% of total taxa richness. In addition, the diversity and richness of collector-gatherers differed significantly between degraded and unimpacted sites, reflecting the sensitivity of this group to environmental changes and the utility to be used in the assessment of anthropogenic modifications. The results of this study reinforce the idea that riparian corridor management is critical for the distribution of macroinvertebrate assemblages as well as functional organization of lotic streams.

Capillariidae Eggs Found in the Urine of a Free Ranging Maned Wolf from Argentina

The first finding of a Capillariid in the urinary tract of a free ranging maned wolf (Chrysocyon brachyurus) is described. The individual was an adult male attacked by dogs in the locality of Cayastacito (Santa Fe, Argentina, 31º05' S, 60º 34' W). Eggs found in urine measured 64.6-66.9µm (mean 65.4µm) x 26.9-31µm (mean 29µm). Further studies are needed to determine whether this finding corresponds to a new Capillariid species, related to C. brachyurus, or it is an already described species that has been introduced by domestic dogs.

Development of genital plates in nymphs of Triatoma pallidipennis, Stål 1872, (Hemiptera: Reduviidae) and its application as sexing method

Searching for morphometric differences between sexes in immature forms, the development of genital plates in the exuviae of Triatoma pallidipennis Stål 1872nymphs was studied. Differences were found in the form and size of the 9th genital urosternite, it is larger and wider in males as compared to females. This difference is reported in several South American Triatoma species. From our results it is possible to sex early stages from microscopic observation of genital plates in whole insects.

Quantitative paleoparasitology applied to archaeological sediments

Three techniques to extract parasite remains from archaeological sediments were tested. The aim was to improve the sensibility of recommended paleoparasitological techniques applied in archaeological remains. Sediment collected from the pelvic girdle of a human body found in Cabo Vírgenes, Santa Cruz, Argentina, associated to a Spanish settlement founded in 1584 known as Nombre de Jesús, was used to search for parasites. Sediment close to the skull was used as control. The techniques recommended by Jones, Reinhard, and Dittmar and Teejen were used and compared with the modified technique presented here, developed to improve the sensibility to detect parasite remains. Positive results were obtained only with the modified technique, resulting in the finding of Trichuris trichiura eggs in the sediment.

Health at the time of Native-European contact in Southern Patagonia: First steps, results, and prospects

The objective of this paper is to present the first steps into the study of health in southern Patagonia during pre and post Native-European contact. Thus, our work has a double purpose. First, to discuss characteristics and relevance of human bone records of southern Patagonia, in order to study health in a population context. Second, to show some new lines of information, which include paleoparasitology, nutritional paleopathologies, and the study of lifestyles from human remains. In this context, we have started working on the first Spanish settlement "Nombre de Jesus", founded in 1584, and with historical documentation of "La Candelaria" Mission in Rio Grande (1896-1931).

Polymorphisms of toll-like receptor 2 and 4 genes in Chagas disease

The aim of this study was to test the possible implication of toll-like receptor 2 (TLR2) and TLR4 gene polymorphisms in determining the susceptibility to Chagas' disease. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism in 475 individuals from Colombia, 143 seropositive with chagasic cardiomyopathy, 132 seropositive asymptomatic and 200 seronegative. The TLR2 arginine to glutamine substitution at residue 753(Arg753Gln) polymorphism was absent in the groups analyzed. The TLR4 Asp299Gly and Thr399Ile polymorphisms are in linkage disequilibrium and we observed a very low frequency of these polymorphisms in our study population (2.6% and 1.8% respectively). The overall TLR2 and TLR4 alleles and genotype distribution in seronegative and seropositive were not significantly different. We compared the frequencies between asymptomatic patients and those with chagasic cardiomyopathy and we did not observe any significant differences in the distribution of alleles or genotypes. In summary, this study corroborates the low frequency of TLR2 and TLR4 polymorphisms observed in other populations and suggest that these do not play an important role in Chagas' disease. The validation of these findings in independent cohorts is needed to firmly establish a role for TLR2 and TLR4 variants in Chagas' disease.

Capillaria spp. eggs in Patagonian archaeological sites: statistical analysis of morphometric data

Discriminant analysis was used to identify eggs of Capillaria spp. at specific level found in organic remains from an archaeological site in Patagonia, Argentina, dated of 6,540 ± 110 years before present. In order to distinguish eggshell morphology 149 eggs were measured and grouped into four arbitrary subsets. The analysis used on egg width and length discriminated them into different morphotypes (Wilks' lambda = 0.381, p < 0.05). The correlation analysis suggests that width was the most important variable to discriminate among the Capillaria spp. egg morphotypes (Pearson coefficient = 0.950, p < 0.05). The study of eggshell patterns, the relative frequency in the sample, and the morphometric data allowed us to correlate the four morphotypes with Capillaria species.

Parasites in rodent coprolites from the historical archaeological site Alero Mazquiarán, Chubut Province, Argentina

The aim of this study was to examine the parasitic remains that were found in rodent coprolites collected from the archaeological site Alero Mazquiarán (Chubut Province, 45º44'15"S, 70°25'9"W), which is assigned to the interface of the Araucanian and Tehuelche cultures, dated at 212 ± 35 years B.P. The faecal material from two unidentified rodent species (X-10 and X-11) was collected from one human pelvic cavity found in a multiple burial. The faecal samples were processed and examined using paleoparasitological procedures. The X-10 coprolites were positive for eggs of Monoecocestus sp. (Cestoda: Anoplocephalidae) and the X-11 faeces were positive for Pterygodermatites sp. (Nematoda: Rictulariidae), Trichosomoides sp. (Nematoda: Trichosomoididae) and Monoecocestus sp. In this study, we discuss parasitic life cycles, the zoonotic importance of parasites and the behaviour of the aboriginal people.

Zoonotic parasites associated with felines from the Patagonian Holocene

Feline coprolites were examined for parasites with the aim of studying ancient infections that occurred in the Patagonian region during the Holocene period. Eggs compatible to Trichuris sp., Calodium sp., Eucoleus sp., Nematodirus sp., Oesophagostomum sp. (Nematoda), Monoecocestus sp. (Cestoda) and Eimeria macusaniensis (Coccidia) were recovered from faecal samples. The results obtained from the analysis provide evidence of consumption by felids of the viscera of both rodents and camelids. This knowledge allows for improved explanations as to the distribution of parasitism and its significance to the health of humans and animals inhabiting the area under study during the Middle Holocene.

Paleoparasitological results for rodent coprolites from Santa Cruz Province, Argentina

The aim of this study was to examine the parasite remains present in rodent coprolites collected from the archaeological site Alero Destacamento Guardaparque (ADG) located in the Perito Moreno National Park (Santa Cruz Province, 47º57'S 72º05'W). Forty-eight coprolites were obtained from the layers 7, 6 and 5 of ADG, dated at 6,700 ± 70, 4,900 ± 70 and 3,440 ± 70 years BP, respectively. The faecal samples were processed and examined using paleoparasitological procedures. A total of 582 eggs of parasites were found in 47 coprolites. Samples were positive for eggs of Trichuris sp. (Nematoda: Trichuridae), Calodium sp., Eucoleus sp., Echinocoleus sp. and an unidentified capillariid (Nematoda: Capillariidae) and for eggs of Monoecocestus (Cestoda: Anoplocephalidae). Quantitative differences among layer for both coprolites and parasites were recorded. In this study, the specific filiations of parasites, their zoonotic importance, the rodent identity, on the basis of previous zooarchaeological knowledge, and the environmental conditions during the Holocene in the area are discussed.