Associação entre marcadores de inflamação e aumento do átrio esquerdo em pacientes de hemodiálise

FUNDAMENTO: Em indivíduos com doença renal crônica e doença cardiovascular (DCV) concomitante, apontou-se relação entre o volume do átrio esquerdo (AE) e os níveis séricos de proteína C reativa (PCR). OBJETIVO: Verificar a presença de associações entre inflamação sistêmica e dilatação do AE em pacientes de hemodiálise (HD) sem DCV clinicamente manifesta. MÉTODOS: Estudo observacional transversal em população sob HD (> 3 meses), excluindo-se pacientes com afecções inflamatórias crônicas ou agudas (infecções, neoplasias, doenças autoimunes) instabilidade hemodinâmica, uso de drogas anti-inflamatórias, hiperparatireoidismo, arritmias, valvopatia mitral e evento cardiovascular (CV) prévio. Dosagens de PCR e interleucina 6 (IL-6), e ecodopplercardiograma foram obtidos. Coeficientes de correlação foram determinados para avaliar as associações entre as variáveis. RESULTADOS: Incluídos 58 pacientes (28 homens, idade 55 ± 15 anos), sob HD há 24 ± 16 meses, 45% hipertensos, 26% diabéticos, com medianas de PCR 5,1 mg/dl e IL-6 6,1 pg/dl. A PCR correlacionou-se significativamente com dimensão do AE (p = 0,040), volume indexado do AE (VIAE, p = 0,02) e onda E do fluxo mitral (p = 0,014). A IL-6, apesar da forte associação com a PCR (r = 0,75, p < 0,001), não se correlacionou com índices ecocardiográficos. Indivíduos no quartil superior da PCR tiveram VIAE significativamente maior do que os demais (42 ± 17 versus 32 ± 11 ml/m², p = 0,015). CONCLUSÕES: Em indivíduos sob HD sem evento CV prévio, houve associação entre elevação da PCR e aumento do AE. Os achados sugerem uma ligação entre processos fisiopatológicos relacionados à dilatação atrial esquerda e o estado inflamatório sistêmico de pacientes sob HD.

Blood Pressure Variation Throughout Pregnancy According to Early Gestational BMI: A Brazilian Cohort

Background: The maternal cardiovascular system undergoes progressive adaptations throughout pregnancy, causing blood pressure fluctuations. However, no consensus has been established on its normal variation in uncomplicated pregnancies. Objective: To describe the variation in systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels during pregnancy according to early pregnancy body mass index (BMI). Methods: SBP and DBP were measured during the first, second and third trimesters and at 30-45 days postpartum in a prospective cohort of 189 women aged 20-40 years. BMI (kg/m2) was measured up to the 13th gestational week and classified as normal-weight (<25.0) or excessive weight (≥25.0). Longitudinal linear mixed-effects models were used for statistical analysis. Results: A decrease in SBP and DBP was observed from the first to the second trimester (βSBP=-0.394; 95%CI: -0.600- -0.188 and βDBP=-0.617; 95%CI: -0.780- -0.454), as was an increase in SBP and DBP up to 30-45 postpartum days (βSBP=0.010; 95%CI: 0.006-0.014 and βDBP=0.015; 95%CI: 0.012-0.018). Women with excessive weight at early pregnancy showed higher mean SBP in all gestational trimesters, and higher mean DBP in the first and third trimesters. Excessive early pregnancy BMI was positively associated with prospective changes in SBP (βSBP=7.055; 95%CI: 4.499-9.610) and in DBP (βDBP=3.201; 95%CI: 1.136-5.266). Conclusion: SBP and DBP decreased from the first to the second trimester and then increased up to the postpartum period. Women with excessive early pregnancy BMI had higher SBP and DBP than their normal-weight counterparts throughout pregnancy, but not in the postpartum period.

Reduced Progression of Cardiac Allograft Vasculopathy with Routine Use of Induction Therapy with Basiliximab

AbstractIntroduction:Cardiac allograft vasculopathy (CAV) is a major limitation for long-term survival of patients undergoing heart transplantation (HT). Some immunosuppressants can reduce the risk of CAV.Objectives:The primary objective was to evaluate the variation in the volumetric growth of the intimal layer measured by intracoronary ultrasound (IVUS) after 1 year in patients who received basiliximab compared with that in a control group.Methods:Thirteen patients treated at a single center between 2007 and 2009 were analyzed retrospectively. Evaluations were performed with IVUS, measuring the volume of a coronary segment within the first 30 days and 1 year after HT. Vasculopathy was characterized by the volume of the intima of the vessel.Results:Thirteen patients included (7 in the basiliximab group and 6 in the control group). On IVUS assessment, the control group was found to have greater vessel volume (120–185.43 mm3 vs. 127.77–131.32 mm3; p = 0.051). Intimal layer growth (i.e., CAV) was also higher in the control group (27.30–49.15 mm3 [∆80%] vs. 20.23–26.69 mm3[∆33%]; p = 0.015). Univariate regression analysis revealed that plaque volume and prior atherosclerosis of the donor were not related to intima growth (r = 0.15, p = 0.96), whereas positive remodeling was directly proportional to the volumetric growth of the intima (r = 0.85, p < 0.001).Conclusion:Routine induction therapy with basiliximab was associated with reduced growth of the intima of the vessel during the first year after HT.

Co-administration of Apelin and T4 Protects Inotropic and Chronotropic Changes Occurring in Hypothyroid Rats

AbstractBackground:One of the most important thyroid hormone targets is the cardiovascular system. Hemodynamic changes, such as decreased resting heart rate (HR), myocardial contractility, and cardiac output, and increased diastolic pressure and systemic vascular resistance, have been observed in hypothyroid patients. Moreover, in these patients, ECG changes include sinus bradycardia and low voltage complexes (P waves or QRS complexes).Objective:This study aimed at evaluating the prophylactic effect of apelin on HR changes and QRS voltage that occur in propylthiouracil (PTU)-induced hypothyroid rats.Method:In this study, 48 adult male Wistar rats weighing 170-235g were randomly divided into 6 groups: Control group (normal saline ip injection + tap water gavage); P group (PTU 0.05%, in drinking water); A group (apelin 200 µg.kg-1.day-1, ip); PA group [co-administration of PTU and apelin]; PT group [co-administration of PTU + T4 (0.2 mg/g per day, gavage)]; and PAT group (co-administration of PTU, apelin and T4). All experiments were performed for 28 consecutive days, and then the animals were anesthetized with an ip injection of ketamine (80 mg/kg) and xylazine (12 mg/kg). Lead II electrocardiogram was recorded to calculate HR and QRS voltage.Results:Heart rate and QRS voltage increased more significantly in the hypothyroid group that consumed both apelin and T4 (201 ± 4 beat/min, 0.71 ± 0.02 mv vs. hypothyroid 145 ± 9 beat/min, 0.563 ± 0.015 mv; respectively).Conclusion:The co-administration of apelin and T4 showed a protective effect on QRS voltage and HR in PTU‑induced hypothyroid rats.

Does Ad Hoc Coronary Intervention Reduce Radiation Exposure? – Analysis of 568 Patients

Background:Advantages and disadvantages of ad hoc percutaneous coronary intervention have been described. However little is known about the radiation exposure of that procedure as compared with the staged intervention.Objective:To compare the radiation dose of the ad hoc percutaneous coronary intervention with that of the staged procedureMethods:The dose-area product and total Kerma were measured, and the doses of the diagnostic and therapeutic procedures were added. In addition, total fluoroscopic time and number of acquisitions were evaluated.Results:A total of 568 consecutive patients were treated with ad hoc percutaneous coronary intervention (n = 320) or staged percutaneous coronary intervention (n = 248). On admission, the ad hoc group had less hypertension (74.1% vs 81.9%; p = 0.035), dyslipidemia (57.8% vs. 67.7%; p = 0.02) and three-vessel disease (38.8% vs. 50.4%; p = 0.015). The ad hoc group was exposed to significantly lower radiation doses, even after baseline characteristic adjustment between both groups. The ad hoc group was exposed to a total dose-area product of 119.7 ± 70.7 Gycm2, while the staged group, to 139.2 ± 75.3 Gycm2 (p < 0.001).Conclusion:Ad hoc percutaneous coronary intervention reduced radiation exposure as compared with diagnostic and therapeutic procedures performed at two separate times.

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.

Observações preliminares sôbre caponização de frangos "Leghorn" com estrogênios

The effect of "Capastrol", pellets of diethilstilbestrol at 0,015 g., in 12 weeks S. C. W. Leghorn cockerels, was studied. The results secured are in accordance with those obtained by other authors and can be resumed as follows: 1) paleness and shrunken of the comb, whose size is reduced, in comparison with the controls; 2) no differences in the total weight gain between control and treated lot; 3) size of testis greatly reduced in treated males; 4) improvement of meat by fat deposition in chickens that received treatment.

Circulating Antigens Levels in Different Clinical Forms of the Schistosoma mansoni Infection

With the aim to evaluate the circulating cathodic antigen (CCA) levels in relation to the different clinical phases of Schistosoma sp. infection a sandwich ELISA using monoclonal antibody 5H11 was performed. The sera of three groups of 25 Brazilian patients with acute, intestinal and hepatosplenic forms of S. mansoni infection were tested and compared to a non-infected control group. Patients and control groups were matched for age and sex and the number of eggs per gram of feces was equally distributed among the three patient groups. Sensitivity of 100%, 72%, 52% of the assay was observed for the intestinal, hepatosplenic and acute toxemic groups respectively. The specificity was 100%. Intestinal and hepatosplenic groups presented CCA levels significantly higher in comparison to those observed for acute patients (F-ratio = 2,524; p = 0.000 and F-ratio = 6,314; p = 0.015 respectively). There was no significant difference of CCA serum levels between hepatosplenic and intestinal groups (F-ratio = 1,026; p = 0.316).

New sonographic measures of peripheral nerves: a tool for the diagnosis of peripheral nerve involvement in leprosy

To evaluate ultrasonographic (US) cross-sectional areas (CSAs) of peripheral nerves, indexes of the differences between CSAs at the same point (∆CSAs) and between tunnel (T) and pre-tunnel (PT) ulnar CSAs (∆TPTs) in leprosy patients (LPs) and healthy volunteers (HVs). Seventy-seven LPs and 49 HVs underwent bilateral US at PT and T ulnar points, as well as along the median (M) and common fibular (CF) nerves, to calculate the CSAs, ∆CSAs and ∆TPTs. The CSA values in HVs were lower than those in LPs (p < 0.0001) at the PT (5.67/9.78 mm2) and T (6.50/10.94 mm2) points, as well as at the M (5.85/8.48 mm2) and CF (8.17/14.14 mm2) nerves. The optimum CSA- receiver operating characteristic (ROC) points and sensitivities/specificities were, respectively, 6.85 mm2 and 68-85% for the PT point, 7.35 mm2 and 71-78% for the T point, 6.75 mm2 and 62-75% for the M nerve and 9.55 mm2 and 81-72% for the CF nerve. The ∆CSAs of the LPs were greater than those of the HVs at the PT point (4.02/0.85; p = 0.007), T point (3.71/0.98; p = 0.0005) and CF nerve (2.93/1.14; p = 0.015), with no difference found for the M nerve (1.41/0.95; p = 0.17). The optimum ∆CSA-ROC points, sensitivities, specificities and p-values were, respectively, 1.35, 49%, 80% and 0.003 at the PT point, 1.55, 55-85% and 0.0006 at the T point, 0.70, 58-50% and 0.73 for the M nerve and 1.25, 54-67% and 0.022 for the CF nerve. The ∆TPT in the LPs was greater than that in the HVs (4.43/1.44; p <0.0001). The optimum ∆TPT-ROC point was 2.65 (90% sensitivity/41% specificity, p < 0.0001). The ROC analysis of CSAs showed the highest specificity and sensitivity at the PT point and CF nerve, respectively. The PT and T ∆CSAs had high specificities (> 80%) and ∆TPT had the highest specificity (> 90%). New sonographic peripheral nerve measurements (∆CSAs and ∆TPT) provide an important methodological improvement in the detection of leprosy neuropathy.

Fatores de risco para câncer de colo do útero segundo resultados de IVA, citologia e cervicografia

Este estudo objetivou avaliar a associação entre fatores de risco para câncer de colo do útero e lesões cervicais por HPV comparando-se os resultados da inspeção visual com o ácido acético (IVA), a citologia e a cervicografia. Realizou-se pesquisa de prevalência com 157 mulheres de um centro de saúde de Fortaleza, no período de junho a setembro de 2006. Utilizou-se o SPSS para codificar os dados. Realizaram-se inferências por meio de testes estatísticos (χ2= quiquadrado e RV= razão de verossimilhança). IVA, cervicografia e citologia obtiveram 43,3%, 10,19% e 3,2% de resultados alterados, respectivamente. As variáveis com importante associação às lesões cervicais na IVA foram: idade menor de 20 anos (p= 0,0001); um ou mais parceiros nos últimos três meses (p= 0,015); uso de contraceptivos (p= 0,0008); presença de corrimento vaginal (p= 0,0001); e processo inflamatório moderado ou acentuado (p= 0,0001). Na citologia: baixa escolaridade (p= 0,0001) e elevado pH (p= 0,001). Não se encontrou associação significante na cervicografia.

Avaliação de genótipos de tomateiro tipo Santa Cruz no período de inverno, em Araguari, MG

Desenvolveu-se um trabalho de pesquisa na fazenda Jordão (município de Araguari, MG), na época de inverno, com o objetivo de verificar o desempenho agronômico de genótipos de tomateiro tipo Santa Cruz. Utilizou-se o delineamento experimental de blocos casualizados, com 14 tratamentos (genótipos) e quatro repetições. A parcela experimental foi constituída por duas fileiras com 12 plantas cada, no espaçamento de 1,00 m entre linhas e 0,60 m entre plantas (duas plantas por cova). As colheitas iniciaram-se em 25/8/96 e encerraram em 19/10/96, perfazendo um total de 17. De forma geral, todos os genótipos apresentaram produtividades elevadas, comparativamente ao rendimento médio nacional, principalmente os genótipos Santa Clara I-5300, Débora Plus, Santa Clara, Santa Clara Importada e Santa Clara III, todos com produtividade superior a 125 t/ha, podendo ser recomendados para plantio na região, no período de inverno. Apenas o genótipo Tom-556 e a cultivar Ângela Gigante I-5100 não tiveram peso médio de frutos superior a 100 g. As cultivares Saladinha, Santa Clara Importada, Concord e Jumbo, tiveram peso médio superior a 130 g, os quais se destacaram, também, em porcentagem de frutos tipo extra AA, juntamente com Santa Clara, Santa Clara I-5300, IAC Santa Clara, enquanto os genótipos Tom-556, Tex-015 e Ângela Gigante I-5100, se destacaram em frutos tipo extra A.

Leaching of nitrogen, potassium, calcium and magnesium in a sandy soil cultivated with sugarcane

A lysimeter experiment was carried out with sugarcane aiming to evaluate the leaching of nitrogen derived from either urea (15N) or the soil/sugarcane crop residues. The leaching of K+, Ca2+, and Mg2+ was also evaluated. The experiment was a factorial 2x4. The influencing factors were: firstly, the differential addition of two kinds of sugarcane remains to the soil, simulating conditions of cane- plantation renewal after the cane crop harvest, with and without previous straw removal by burning; secondly, four doses of N: 0, 30, 60, and 90 kg ha-1. During the experimental period the total volume of water received by the sugarcane-soil system was 2,015 mm, with 1,255 mm as precipitation and 760 mm as irrigation. The loss of N by leaching from the fertilizer (15N) was not detected. In the first three weeks the largest losses of N by leaching occurred, originating from the soil/sugarcane remains-N. The mean of leached N during the experimental period of 11 months was of 4.5 kg ha-1. The mean losses of K+, Ca2+, and Mg2+ were of 13, 320 and 80 kg ha-1, respectively.

Diversity of springtails (Hexapoda) according to a altitudinal gradient

The objective of this work was to elevate gradient effect on diversity of Collembola, in a temperate forest on the northeast slope of Iztaccíhuatl Volcano, Mexico. Four expeditions were organized from November 2003 to August 2004, at four altitudes (2,753, 3,015, 3,250 and 3,687 m a.s.l.). In each site, air temperature, CO2 concentration, humidity, and terrain inclination were measured. The influence of abiotic factors on faunal composition was evaluated, at the four collecting sites, with canonical correspondence analyses (CCA). A total of 24,028 specimens were obtained, representing 12 families, 44 genera and 76 species. Mesaphorura phlorae, Proisotoma ca. tenella and Parisotoma ca. notabilis were the most abundant species. The highest diversity and evenness were recorded at 3,250 m (H' = 2.85; J' = 0.73). Canonical analyses axes 1 and 2 of the CCA explained 67.4% of the variance in species composition, with CO2 and altitude best explaining axis 1, while slope and humidity were better correlated to axis 2. The results showed that CO2 is an important factor to explain Collembola species assemblage, together with slope and humidity.

Meta-análise de parâmetros genéticos relacionados ao consumo alimentar residual e a suas características componentes em bovinos

O objetivo deste trabalho foi estimar, por meio de meta-análise, a herdabilidade (h²) e as correlações genética (r g) e fenotípica (r f) do consumo alimentar residual (CAR), e das suas características componentes, em bovinos de 19 raças ou grupamentos genéticos. Foram utilizados 22 trabalhos científicos publicados entre 1963 e 2011, de oito países, o que totalizou 52.637 bovinos com idades que variaram de 28 dias até a idade de abate. As estimativas de CAR, consumo de matéria seca (CMS), ganho médio diário (GMD) e peso metabólico (PV0, 75) foram ponderadas pelo inverso da variância amostral. A variação da h² de cada característica entre os estudos foi analisada por quadrados mínimos ponderados. Os efeitos de sexo, país e raça foram significativos para h² de CAR e explicaram 67% da variação entre os estudos. Para CMS, os efeitos de país e raça foram significativos e explicaram 96% da variação. As estimativas combinadas de h² foram: 0, 255±0, 008, 0, 278±0, 012, 0, 321±0, 015 e 0, 397±0, 032 para CAR, CMS, GMD e PV0, 75, respectivamente. As estimativas combinadas de correlação genética e fenotípica foram baixas entre CAR e GMD e entre CAR e PV0, 75 (de -0, 021±0, 034 a 0, 025±0, 035), e de média magnitude entre CAR e CMS (0, 636±0, 035 a 0, 698±0, 041) e entre CMS, GMD e PV0, 75 (0, 441±0, 062 a 0, 688±0, 032). O CAR apresenta estimativa de herdabilidade menor que a de suas características componentes.

Interação P x Fe em mudas de macadâmia

Com objetivo de avaliar a interação P x Fe e seus efeitos no crescimento de mudas de macadâmia, foi conduzido um experimento na Universidade Federal de Viçosa, em solução nutritiva. Sete concentrações de P e de Fe foram combinadas de acordo com a matriz experimental Box-Berard aumentada (3), modificada, constituindo 14 tratamentos, em cinco repetições. Concentrações de Fe na solução nutritiva variando entre 0,136 e 0,289 mmol L-1 reduziram em até 33% os teores de P nas folhas inferiores de plantas de macadâmia. Os teores de P nas folhas, nos tratamentos com a menor concentração de P e com concentrações de Fe variando entre 0,015 e 0,289 mmol L-1, mantiveram-se superiores às adequadas. Em solução nutritiva, a concentração de P pode ser menor que 0,03 mmol L-1. Os teores de Fe nas folhas de macadâmia aumentaram com a elevação da concentração de Fe na solução nutritiva e não foram afetados pela concentração de P. No espaço experimental explorado a relação Fe (mg kg)-1 : P (g kg) -1 foi menor que 60, sugerindo que as folhas das plantas estariam com deficiência de Fe.