Use of Short-term Circulatory Support as a Bridge in Pediatric Heart Transplantation

Background:Heart transplantation is considered the gold standard therapy for the advanced heart failure, but donor shortage, especially in pediatric patients, is the main limitation for this procedure, so most sick patients die while waiting for the procedure.Objective:To evaluate the use of short-term circulatory support as a bridge to transplantation in end-stage cardiomyopathy.Methods:Retrospective clinical study. Between January 2011 and December 2013, 40 patients with cardiomyopathy were admitted in our Pediatric Intensive Care Unit, with a mean age of 4.5 years. Twenty patients evolved during hospitalization with clinical deterioration and were classified as Intermacs 1 and 2. One patient died within 24 hours and 19 could be stabilized and were listed. They were divided into 2 groups: A, clinical support alone and B, implantation of short-term circulatory support as bridge to transplantation additionally to clinical therapy.Results:We used short-term mechanical circulatory support as a bridge to transplantation in 9. In group A (n=10), eight died waiting and 2 patients (20%) were transplanted, but none was discharged. In group B (n=9), 6 patients (66.7%) were transplanted and three were discharged.The mean support time was 21,8 days (6 to 984h). The mean transplant waiting list time was 33,8 days. Renal failure and sepsis were the main complication and causeof death in group A while neurologic complications were more prevalent en group B.Conclusion:Mechanical circulatory support increases survival on the pediatric heart transplantation waiting list in patients classified as Intermacs 1 and 2.

Análise de áreas com diferentes classes de declividade através de imagens TM/LANDSAT

É feita a análise de áreas com diferentes classes de declividade (A = 0-3%, B = 3-8%, C = 8-16% e D = 16-30%) sscom a fina1idade de se verificar a potencialidade de imagens TM/LANDSAT, na escala 1:100.000, para planejamento agrícola. Devido à ausência de visão tridimensional, o trabalho baseia-se nas relações quantitativas entre índices dedrenagem (freqüência de rios e densidade de drenagem) determinados a partir das imagens, e expressão do relevo (declividade média) extraída de cartas planialtimétricas, na escala 1:50.000. Fotografias aéreas na escala 1:35.000 são utilizadas para fins comparativos. Conclui-se que o uso dessas imagens para mapear classes de declividade através do padrão de drenagem é viável, embora as características regionais o tenham limitado para diferenciar mais facilmente áreas com declividades A e B de áreas com declividades C e D.

Classes de comprimento e proporção sexual em Diplodon expansus (Mollusca, Bivalvia, Hyriidae) no rio Piraquara, Paraná, Brasil

O presente estudo tem como objetivo analisar a distribuição de classes de tamanho e proporção sexual ampliando o conhecimento do comportamento reprodutivo de Diplodon expansus (Küster, 1856) e da biodiversidade dos corpos de água da Área de Proteção Ambiental do Piraquara, Paraná, Brasil. A área de estudo corresponde a um trecho do rio Piraquara de águas lóticas, e mata ciliar relativamente bem preservada. Foram realizadas quatro coletas no período de março de 2006 a dezembro de 2006. No rio Piraquara o D. expansus ocorre em substratos arenoso e lodoso. O comprimento dos exemplares variou entre 17 mm e 65 mm, sendo que a maior frequência de classes de comprimento foi registrada para as classes intermediárias. A análise histológica das gônadas possibilitou a determinação de uma razão sexual 1:1, não tendo sido identificado nenhum exemplar hermafrodita, caracterizando uma população tipicamente dióica. Análises qualitativas e quantitativas demonstram uma gametogênese contínua, com picos de liberação larval no verão.

Variação sazonal no recrutamento de Phragmatopoma caudata (Polychaeta, Sabellariidae) na costa sudeste do Brasil: biometria e validação de metodologia para categorização de classes etárias

Este estudo explora a maturação de gametas e biometria de Phragmatopoma caudata Krøyer in Mörch, 1863 para endossar uma metodologia e oferecer uma técnica adequada para estudos que objetivam avaliar a ecologia populacional. A análise de correlação de Pearson confirmou a relação positiva (r = 0,90, P <0,0001) entre o comprimento do corpo e o comprimento da coroa opercular. Indivíduos com opercular crown < 0,9 mm podem ser considerados como juvenil devido à ausência de gametas. Portanto, utilizando-se o método aprovado para separar as classes de tamanho, a população dos recifes de P. caudata no Parque Estadual Xixová-Japuí (PEJX) na Baía de Santos, Estado de São Paulo, foi examinada durante dois anos, com o objetivo de analisar a densidade populacional e o padrão sazonal da classe juvenil. Em período de elevadas taxas de juvenis, a densidade populacional atingiu 128.115 ind./m², porém, a média foi 65.090±22.033 ind./m². As análises estatísticas (Kruskal-Wallis H = 18,475, p < 0,01) revelaram existir variação significativa na composição juvenil entre as estações chuvosa e seca. Apesar da presença de juvenis em meses de seca, as estações chuvosas contemplaram 92,1% dos juvenis amostrados. O padrão de juvenis observado pode estar relacionado com fatores biológicos (e.g. gametogênese e ciclo de vida) e abióticos (e.g. suprimento alimentar e correntes marinhas). Estes resultados destacam a necessidade de programas de monitoramento de longo prazo que integrem elementos ecológicos e abióticos, a fim de obter uma compreensão mais completa da ecologia desse poliqueta e ajudar a gerenciar a biodiversidade marinha do PEJX.

Avaliação da incidência da toxicidade de amostras de Bacillus cereus em diferentes classes de alimentos comercializados e consumidos no Estado do Rio de Janeiro

Cento e quatorze amostras de Bacilus cereus foram isoladas durante contagens presuntivas em placas a partir de dezoito grupos de alimentos, industrializados não, crus ou cuzidos, pertencentes a dez classes. As contagens presuntivas para a espécie variam entre 10 [ao quadrado] a 6 x 10 [ao cubo]/g ou ml. Dentre estes isolamentos, treze amostras provieram de três casos de toxinfecção alimentar (envolvendo um mínimo de 57 indivíduos), e pareceram estar relacionadas com a toxinfecção em razão dos ensaios da qualidade bacteriológica dos alimentos ingeridos. Como procedimento adotado para correlacionar toxicidade e produção de doença no homem., os fluidos de cultivo de todas as amostras foram ensaiados quanto à capacidade de provocar aumento da permeabilidade capilar (APC) e necrose na pele de coelhos, assim como,morte de camundongos albinos. APC foi positivo em 86,85% das 114 amostras, morte de camundongos ocorreu em 65,79% e a combinação do APC e morte foi observada em 59,65% APC mais necrose ou somente necrose ocorreram com 34,21% dos líquidos de cultivo. Morte, APC e necrose,associados,foram observados em 28,07% das amostras. APC,APC e morte com ou sem necrose, foram também evidenciadas nas amostras originárias de alimentos causadores de doença, o que confirma a conhecida individualidade de ação de alguns dos fatores promotores de intoxicação alimentar. As baixas contagens presuntivas de B. cereus, como 10 [ao quadrado]- 10 [ao cubo]/g ou ml, encontradas nos alimentos implicados ou não com toxinfecção alimentar, conduzem à recomendaçãode que o número de B. cereus por g ou ml de amostra de alimento deve ser reavalido, aliando-se a isto a ampliação das classes de alimentos a serem conduzidas para o controle bacteriológico da espécie.

Further support for a palaearctic origin of Leishmania

The fossil record and systematics of murid rodents, reservoirs of zoonotic cutaneous leishmaniasis in the Palaearctic, Oriental, African, Nearctic and Neotropical, strongly support a Palaearctic origin of Leishmania. The fossil record and systematics of phlebotomine sand flies reinforce this idea. Interpretations of molecular data that place the origin of Leishmania in the Neotropical are inconsistent with the natural histories of reservoirs and vectors. The evolutionary pattern of New World rats (Sigmodontinae) indicates that they may be the most important reservoirs of zoonotic cutaneous leishmaniasis throughout their range.

Re-mapping the molecular features of the human immunodeficiency virus type 1 and human T-cell lymphotropic virus type 1 Brazilian sequences using a bioinformatics unit established in Salvador, Bahia, Brazil, to give support to the viral epidemiology studies

The analysis of genetic data for human immunodeficiency virus type 1 (HIV-1) and human T-cell lymphotropic virus type 1 (HTLV-1) is essential to improve treatment and public health strategies as well as to select strains for vaccine programs. However, the analysis of large quantities of genetic data requires collaborative efforts in bioinformatics, computer biology, molecular biology, evolution, and medical science. The objective of this study was to review and improve the molecular epidemiology of HIV-1 and HTLV-1 viruses isolated in Brazil using bioinformatic tools available in the Laboratório Avançado de Sáude Pública (Lasp) bioinformatics unit. The analysis of HIV-1 isolates confirmed a heterogeneous distribution of the viral genotypes circulating in the country. The Brazilian HIV-1 epidemic is characterized by the presence of multiple subtypes (B, F1, C) and B/F1 recombinant virus while, on the other hand, most of the HTLV-1 sequences were classified as Transcontinental subgroup of the Cosmopolitan subtype. Despite the high variation among HIV-1 subtypes, protein glycosylation and phosphorylation domains were conserved in the pol, gag, and env genes of the Brazilian HIV-1 strains suggesting constraints in the HIV-1 evolution process. As expected, the functional protein sites were highly conservative in the HTLV-1 env gene sequences. Furthermore, the presence of these functional sites in HIV-1 and HTLV-1 strains could help in the development of vaccines that pre-empt the viral escape process.

Synthesis of limonene β-amino alcohol derivatives in support of new antileishmanial therapies

A series of seven limonene β-amino alcohol derivatives has been regioselectively synthesised in moderate to good yields. Two of these compounds were found to be significantly effective against in vitro cultures of the Leishmania (Viannia) braziliensis promastigote form in the micromolar range. The activities found for 3b and 3f were about 100-fold more potent than the standard drug, Pentamidine, in the same test, while limonene did not display any activity. This is the first report of antileishmanial activity by limonene β-amino alcohol derivatives.

Molecular phylogeny of the Myzorhynchella Section of Anopheles (Nyssorhynchus) (Diptera: Culicidae): genetic support for recently described and resurrected species

Phylogenetic relationships among species of the Myzorhynchella Section of Anopheles (Nyssorhynchus) were investigated using the nuclear ribosomal DNA second internal transcribed spacer (ITS2), the nuclear whitegene and mitochondrial cytochrome oxidase subunit I (COI) regions. The recently described Anopheles pristinus and resurrected Anopheles guarani were also included in the study. Bayesian phylogenetic analyses found Anopheles parvus to be the most distantly related species within the Section, a finding that is consistent with morphology. An. pristinus and An. guarani were clearly resolved from Anopheles antunesi and Anopheles lutzii, respectively. An. lutzii collected in the same mountain range as the type locality were found within a strongly supported clade, whereas individuals from the southern state of Rio Grande do Sul, tentatively identified as An. lutzii based on adult female external morphology, were distinct from An. lutzii, An. antunesi and from each other, and may therefore represent two new sympatric species. A more detailed examination of An. lutzii sensu latoalong its known geographic range is recommended to resolve these anomalous relationships.

Whole-cell antigenicity data support sequence-based kinetoplastid taxonomy

Early immunological data, obtained by immunodiffusion and immunoelectrophoresis, on the whole-cell antigenicity of kinetoplastid protozoa were retrieved and used to construct a dendrogram of antigenic distances. Remarkably, they supported the same taxonomic conclusions as analyses based on DNA and protein sequence data.

The use of expert systems on the differential diagnosis of urinary incontinence

The differential diagnosis of urinary incontinence classes is sometimes difficult to establish. As a rule, only the results of urodynamic testing allow an accurate diagnosis. However, this exam is not always feasible, because it requires special equipment, and also trained personnel to lead and interpret the exam. Some expert systems have been developed to assist health professionals in this field. Therefore, the aims of this paper are to present the definition of Artificial Intelligence; to explain what Expert System and System for Decision Support are and its application in the field of health and to discuss some expert systems for differential diagnosis of urinary incontinence. It is concluded that expert systems may be useful not only for teaching purposes, but also as decision support in daily clinical practice. Despite this, for several reasons, health professionals usually hesitate to use the computer expert system to support their decision making process.

Social support, socioeconomic and clinical risk: comparison between to neighborhoods in a Brazilian upcountry town

The objective of this study was to compare the perceptions of two families living in two different neighborhoods (rated according to risk levels) regarding social support. A questionnaire was designed to assess social support according to the following dimensions: instrumental, emotional, religious, and support from friends, neighbors and family. The sample was comprised as follows: considering the 114 families living in neighborhood 1, 52 families were interviewed; and among the 162 families living in neighborhood 2, 60 families were interviewed. No significant difference was found related to instrumental, religious and emotional support, including the support from relatives among the families from both neighborhoods. The results disagree with the reviewed literature, which indicated a strong association between social support and families living at socioeconomic risk. In conclusion, social support is important for families, regardless of their risk stratification.

Virtual Guide On Ocular Self-Examination To Support The Self-Care Practice For People With HIV/AIDS

Objetivou-se descrever processo de desenvolvimento da cartilha virtual sobre autoexame ocular para pessoas com HIV/aids. A proposta metodológica seguiu as cinco etapas preconizadas por Falkembach: análise e planejamento, modelagem, implementação, avaliação e distribuição. A adequação da versão impressa para virtual requereu a construção de um vídeo tutorial, agregação de fotos ilustrativas para visualização de possíveis alterações oculares e ferramenta de interatividade com demonstração do resultado do exame ao usuário. Na avaliação inicial do material, foram diagnosticadas falhas no layout. Assim, comandos foram recolocados, unificados, dispostos em local de fácil visualização e foi feita a adequação da linguagem. Considera-se possível promover aproximação do usuário com métodos de prevenção na área da saúde ocular por meio de cartilha virtual, contribuindo para desenvolvimento de habilidades e divulgação do autoexame.


The network social support experience of people involved in home care

Objective: To build a theoretical model to configure the network social support experience of people involved in home care. Method: A quantitative approach research, utilizing the Grounded Theory method. The simultaneous data collection and analysis allowed the interpretation of the phenomenon meaning The network social support of people involved in home care. Results: The population passive posture in building their well-being was highlighted. The need of a shared responsibility between the involved parts, population and State is recognized. Conclusion: It is suggested for nurses to be stimulated to amplify home care to attend the demands of caregivers; and to elaborate new studies with different populations, to validate or complement the proposed theoretical model.