Tratamento de estenose de veia pulmonar após ablação percutânea de fibrilação atrial

Neste relato de caso, descrevemos um paciente portador de fibrilação atrial (FA) persistente, submetido à ablação percutânea da FA pela técnica de isolamento extraostial das veias pulmonares, que desenvolveu uma estenose acentuada do óstio da veia pulmonar superior esquerda (VPSE), sem manifestar sintomas, diagnosticada pela angiotomografia de controle das veias pulmonares. O paciente foi submetido à angioplastia com implante de stent na VPSE com sucesso, resultando na normalização da perfusão pulmonar, verificado pela cintilografia pulmonar realizada 3 meses após a angioplastia.

Aneurisma coronariano micótico: relato de dois casos

O número de intervenções percutâneas com implante de stents tem aumentado dramaticamente nos últimos anos, apesar da frequência no uso do dispositivo nos relatos de infecções serem extremamente raros. Neste artigo relatamos dois casos de aneurisma micótico após implante de stents com diferentes apresentações clínicas e evolução

Role of microRNAs 221/222 on Statin Induced Nitric Oxide Release in Human Endothelial Cells

Background: Nitric oxide (NO) has been largely associated with cardiovascular protection through improvement of endothelial function. Recently, new evidence about modulation of NO release by microRNAs (miRs) has been reported, which could be involved with statin-dependent pleiotropic effects, including anti-inflammatory properties related to vascular endothelium function. Objective: To evaluate the effects of cholesterol-lowering drugs including the inhibitors of cholesterol synthesis, atorvastatin and simvastatin, and the inhibitor of cholesterol absorption ezetimibe on NO release, NOS3 mRNA expression and miRs potentially involved in NO bioavailability. Methods: Human umbilical vein endothelial cells (HUVEC) were exposed to atorvastatin, simvastatin or ezetimibe (0 to 5.0 μM). Cells were submitted to total RNA extraction and relative quantification of NOS3 mRNA and miRs -221, -222 and -1303 by qPCR. NO release was measured in supernatants by ozone-chemiluminescence. Results: Both statins increased NO levels and NOS3 mRNA expression but no influence was observed for ezetimibe treatment. Atorvastatin, simvastatin and ezetimibe down-regulated the expression of miR-221, whereas miR-222 was reduced only after the atorvastatin treatment. The magnitude of the reduction of miR-221 and miR-222 after treatment with statins correlated with the increment in NOS3 mRNA levels. No influence was observed on the miR-1303 expression after treatments. Conclusion: NO release in endothelial cells is increased by statins but not by the inhibitor of cholesterol absorption, ezetimibe. Our results provide new evidence about the participation of regulatory miRs 221/222 on NO release induction mediated by statins. Although ezetimibe did not modulate NO levels, the down-regulation of miR-221 could involve potential effects on endothelial function.

Influência do carvão na alimentação das aves

Dois lotes de 50 pintos foram submetidos, durante 25 dias, ao mesmo regime, salvo que um (A) recebeu 5% de carvão na farelada e outro (B) não. No fim da experiência, a média de peso do lote A era 174,9 grs. e a do lote B, 262,2; a diferença é significativamente favorável ao lote B em relação ao peso, contudo a mortalidade foi maior (12%) no lote que não recebeu carvão. A aparência geral dos pintos do lote B era muito melhor. Os AA. concluem que o carvão não deve ser usado como alimento, provavelmente por absorver muitas subtâncias úteis à nutrição, possivelmente vitaminas e amino-ácidos, mas sim para os pintos que se atrazam no crescimento devido a perturbações do aparelho digestivo, como um medicamento. Esta última conclusão depende de ulterior comprovação, pois a maior mortalidade constatada no lote sem carvão pode ser devida ao acaso, simplesmente.

Shell utilization pattern of the hermit crab Clibanarius vittatus (Crustacea, Anomura) in an estuary at São Vicente, State of São Paulo, Brazil

We evaluated the gastropod shell utilization pattern of the hermit crab Clibanarius vittatus (Bosc, 1802) at Pescadores Beach in São Vicente, State of São Paulo, Brazil. Specimens were collected monthly from May 2001 through April 2003, in the intertidal zone at low tide. The crabs were weighed and their carapace shield length measured. All gastropod shells were identified and had their shell biometric parameters (total length and aperture length) measured (mm) and weighed (g). A total of 2,344 hermit crabs (644 males, 1,594 females, 45 ovigerous females and 61 individuals in intersex), using 13 species of gastropod shells, were collected. Stramonita haemastoma (Linnaeus, 1767), Cymatium parthenopeum (Von Salis, 1793) and Achatina fulica (Bowdich, 1822) comprised over 98% of all the shells. Male and intersex crabs were significantly larger than the females. This size difference strongly influenced the shell utilization pattern, principally in A. fulica, which has the largest shell size, that was only used by males and intersexual individuals of C. vittatus. Cymatium parthenopeum was the only shell species that showed a high determinant coefficient in all the biometric correlations evaluated. The high abundance of S. haemastoma shells and a strong correlation between crab size and shell aperture length established by a significant determination coefficient, indicated that C. vittatus uses this species as the principal resource for shell occupation at Pescadores Beach.

Hemograma do coelho normal e mixomatoso

O autor procurou estabelecer os dados relativos ao hemograma de coelho normal, do biotério do Instituto Oswaldo Cruz, encontrando as seguintes médias: hematias 5.186.000 por mm3, leucócitos 10.419 por mm3, e na contagem específica os seguintes valores para Heterófilos 40%, basófilos 2.5%, eosinófilos 0.2%, monócitos 6.5% e linfócitos 50%, e células de Tuerk 0.8%. Pode o autor confirmar o achado de AGOSIN, referente à presença de células morfológicamente semelhantes ás de TUERK, no sangue periférico dos coelhos normais. Realizou ainda, uma revisão bibliográfica do assunto.

Infecção natural das glândulas anais de gambás (Didelphis albiventris) pelo Trypanosoma cruzi no município de Bambuí - MG

De 87 gambás, Didelphis albiventris, capturados na região de Bambuí (MG), 32 (36,7%) estavam infectados pelo Trypanosoma cruzi. Os índices de infecção foram 34,9%, 81,8% e 7,7%, respectivamente, para animais capturados em ambiente silvestre, peridomiciliar rural e periodomiciliar urbano. Em 20 gambás infectados as glândulas anais foram examinadas repetidamente e apenas um (5%) animal (GA09) apresentou exame positivo. Foram positivos 7 dos 17 exames a fresco da secreção glandular desta animal ao longo de 18 meses. Material destas glândulas produziu parasitemia patente em gambás e infecção subpatente em camundongos. A análise isoenzimática realizada com amostras de T. cruzi do GA09, obtidas via hemocultura, xenodiagnóstico e glândulas anais demonstraram pertencerem rigorosamente ao mesmo Zimodema semelhante ao Zimodema Z1. As observações mostram que a infecção das glândulas anias pelo T. cruzi em gambás naturalmente infectados da região de Bambuí é baixa.

Isolamento de amostras do Trypanosoma cruzi por xenodiagnóstico e hemocultura de pacientes na fase crônica da doença de Chagas

Cinquenta e nove pacientes chagásicos crônicos foram submetidos a xenodiagnósticos e hemocultura concomitantes para isolamento de amostras de Trypanosoma cruzi. O xenodiagnóstico foi composto de 40 ninfas de Panstrongylus megistrus, Triatoma infestans e Dipetalogylus megistus, Triatoma infestans e Dipetalogaster maximus num total de 120 triatomíneos. Os insetos foram dissecados em grupo de 10 por espécie e o conteúdo intestinal, agrupado, examinado após prévia trituração e homogeneização. O material negativo ao microscópio foi semeado em meio LIT e examinado após 20 dias. Vinte e nove pacientes foram parasitologicamente comprovados, sendo 15 apenas no xenodiagnóstico, quatro apenas com a hemocultura e 10 por ambos os métodos. Discutem-se as dificuldades para a comprovação parasitológica dos pacientes chagásicos crônicos, o valor da utilização simultânea de diferentes espécies de triatomíneos no xenodiagnóstico e a hemocultura, numa associação positiva favorável ao aumento da sensibilidade para o diagnóstico da doença de Chagas. A positividade de 49,2% obtida neste grupo de pacientes visualiza abordagens do tipo ensaio clínico-terapêutico e/ou epidemiológico (tipo caso-controle) com a finalidade de investigar uma possível associação entre amostras do T. cruzi e diferentes formas clínicas da doença de Chagas.

The importance of the opossum (Didelphis albiventris) as a reservoir for Trypanosoma cruzi in Bambuí, Minas Gerais state

In a survey realized on the sylvatic and peridomestic environment at Bambuí county, Minas Gerais State, 44 (37.9%) out of 116 opossums (Didelphis albiventris) captured were found to be naturally infected with Trypanosoma cruzi. One handred and forty three parasite samples were obtanied from 43 infected opossums using simultaneously hemoculture, xenodiagnosis (Triatoma infestans, Panstrongylus megistus and Rhodnius neglectus) and examination of anal glands contents. The parasite samples were characterized according to six isoenzyme patterns. All samples, independently of the method of isolation, presented an isoenzyme pattern similar to the standard T. cruzi Z1, showing that either xenodiagnosis or hemoculture can used without selecting parasite subpopulation from naturally infected opossums. Preveous isoenzyme patterns reported for human T.cruzi isolates from same region were completely different. This isoenzyme dissimilarity between sylvatic and domiciliar environments suggests the existence of two independent T. cruzi transmission cycles in Bambuí. The epidemiological implicatinos of these results are discussed.

Lectin receptors distribution in the surface membrane of Trypanosoma cruzi blood forms collected from mice submitted to specific treatment

The author investigated the distribution of lectin receptors on Trypanosoma cruzi blood forms collected from mice inoculated with, respectively, the drug-resistant and drug-sensitive strains VL-10 and CL, and treated with the two standard active nitroheterocyclic compounds nifurtimox and benznidazole used for treatment of human Chagas' disease. Blood trypomastigotes purified in Fycoll-Hypaque were incubated with fluorescein-labelled lectins Con A, WGA, EE, WFA, TPA and PNA and then microscopically examined. Neither qualitative or quantitative differences in the fluorescence intensity could be detected between parasites from VL-10 and CL strains submitted or not to treatment. The results suggest that both strains do not differ in their surface membrane carbohydrate moieties. Moreover, the rapid clearance of blood forms the drug-sensitive strain in animals treated with singlo doses of both compounds is not likely to depend on membrane alterations expressed by changes in the carbohydrate components. furthermore, resistance or sensitivity to drugs is not apparently related to carbohydrate distribution on T. cruzi blood forms.

Stability of isoenzyme and kinetoplast DNA (k-DNA) patterns in successively cloned Trypanosoma cruzi populations

Four Trypanosoma cruzi strains from zymodermes A, B, C and D were successively clonedon BHI-LIT-agar-blood BLAB). Twenty clones from the first generation (F1), 10 from The second (F2) and 4 from the third (F3) from the strains A138, B147 and C23 were isolated. The D150 strain provied 29 F1 and F2 clones. The strains and clones had their isoenzyme and K-DNA patterns determined. The clones from A138, Bl47 and C231 strains presented isoemzyme and K-DNA patterns identical between thewmselves and their respective parental strains. Therefore showing the homogenety and stability of isoenzyme and K-DNA patterns after successive cloning. The Dl50 strain from zymodeme D (ZD) showed heterogeneity. Twenty-eight out of 29 clones of the first generation were of zymodeme A and only one was of zymodeme C, confirming previous reports that ZD strains consisted of ZA and ZC parasite populations. The only D150 strain clone of zymodeme C showed a K-DNA pattern identical to its parental strain. The remining clones although similar among themselves were different from the parental strain. Thus the T. cruzi strains had either homonogeneus or heterogeneous populations. The clones produced by successive cloning provided genetically homonogeous populations. Their experimental use will make future results more reliable and reproducible.

The threat of reintroduction of natural transmission of Chagas' disease in Bambuí, Minas Gerais state, Brazil, due to Panstrongylus megistus

In the Epidemiological Surveillance Program in the county of Bambuí, Minas Gerais, between August 1986 and December 1988, 154 Panstrongylus megistus were captured by the local population in both peridomicile and intradomicile environments. Fifteen (9.8%) of the P. megistus harboured Trypanosoma cruzi. Preciptin tests showed that the most frequent triatomine blood meal sources were birds, but other sources were dogs, men and cats. The isoenzyme characterization of 13 T. cruzi strains showed that six belonged to zymodeme Z1, corresponding to the wild parasites, and seven belonged to zymodeme Z2, corresponding to parasites isolated from chronic chagasic patients (domestic cycle). As P. megistus were found to be naturally infected by parasites from both cycles, they are cleary able to transmit T. cruzi from the wild cycle to the domestic cycle. Furthermore the capacity of P. megistus in colonizing houses was observed in one residence, vacant for several years, in wich 153 triatomines were captured. The data show the possibility of P. megistus reintroducing transmission of Chaga's disease in the county if Epidemiological Surveillance is interrupted.

Crithidia ricardoi sp. n. a new species of trypanosomatidae isolated from Culex saltanensis Dyar, 1928 (Diptera: Culicidae)

A flagellte trypanosomatid was isolated in culture from the digestive tract of the mosquito Culex saltanensis Dyar, 1928. It grows exuberantly in liver infusion in the form of epimastigotes and choanomastigotes typical of the genus Crithidia. The trypanosomatid was compared to C. deanei, C. fasciculata, C. luciliae, C. oncopelti and C. guilhermei. The techniques used for comparison were electron transmission microscopy, isoenzymes and kDNA restriction profiles. No endosymbionts were found at electron microscopy. Results for the biochemical methods employd indicate that the trypanosomatid isolated from C. saltanensis is a new species of Crithidia. The name C. ricardoi sp. n. is proposed for thes new species.