Unsupported valvuloplasty in children with congenital mitral valve anomalies. Late clinical results

OBJECTIVE: To analyze late clinical evolution after surgical treatment of children, with reparative and reconstructive techniques without annular support. METHODS: We evaluated 21 patients operated upon between 1975 and 1998. Age 4.67±3.44 years; 47.6% girls; mitral insufficiency 57.1% (12 cases), stenosis 28.6% (6 cases), and double lesion 14.3% (3 cases). The perfusion 43.10±9.50min, and ischemia time were 29.40±10.50min. The average clinical follow-up in mitral insufficiency was 41.52±53.61 months. In the stenosis group (4 patients) was 46.39±32.02 months, and in the double lesion group (3 patients), 39.41±37.5 months. The echocardiographic follow-up was in mitral insufficiency 37.17±39.51 months, stenosis 42.61±30.59 months, and in the double lesion 39.41±37.51 months. RESULTS: Operative mortality was 9.5% (2 cases). No late deaths occurred. In the group with mitral insufficiency, 10 (83.3%) patients were asymptomatic (p=0.04). The majorit y with mild reflux (p=0.002). In the follow-up of the stenosis group, all were in functional class I (NYHA); and the mean transvalve gradient varied between 8 and 12mmHg, average of 10.7mmHg. In the double lesion group, 1 patient was reoperated at 43 months. No endocarditis or thromboembolism were reported. CONCLUSION: Mitral stenosis repair has worse late results, related to the valve abnormalities and associated lesions. The correction of mitral insufficiency without annular support showed good long-term results.

Myocardial Scintigraphy in the Evaluation of Cardiac Events in Patients without Typical Symptoms

AbstractBackground:Cardiovascular disease is a leading cause of death in the world and in Brazil. Myocardial scintigraphy is an important noninvasive method for detecting ischemia in symptomatic patients, but its use in asymptomatic ones or those with atypical symptoms is yet to be defined.Objective:To verify the presence of major cardiac events in asymptomatic patients or those with atypical symptoms (atypical chest pain or dyspnea) that underwent myocardial scintigraphy (MS), over a period of 8 years. Secondary objectives were to identify cardiac risk factors associated with myocardial scintigraphy abnormalities and possible predictors for major cardiac events in this group.Methods:This was a retrospective, observational study using the medical records of 892 patients that underwent myocardial scintigraphy between 2005 and 2011 and who were followed until 2013 for assessment of major cardiac events and risk factors associated with myocardial scintigraphy abnormalities. Statistical analysis was performed by Fisher’s exact test, logistic regression and Kaplan-Meyer survival curves, with statistical significance being set at p ≤ 0.05.Results:Of the total sample, 52.1% were men, 86.9% were hypertensive, 72.4% had hyperlipidemia, 33.6% were diabetic, and 12.2% were smokers; 44.5% had known coronary artery disease; and 70% had high Framingham score, 21.8% had moderate and 8% had low risk. Of the myocardial scintigraphies, 58.6% were normal, 26.1% suggestive of fibrosis and 15.3% suggestive of ischemia. At evolution, 13 patients (1.5%) had non-fatal myocardial infarction and six individuals (0.7%) died. The group with normal myocardial scintigraphy showed longer period of time free of major cardiac events, non-fatal myocardial infarction (p = 0.036) and death. Fibrosis in the myocardial scintigraphy determined a 2.4-fold increased risk of non-fatal myocardial infarction and five-fold higher risk of death (odds ratio: 2.4 and 5.7, respectively; p = 0.043).Conclusion:The occurrence of major cardiac events in 8 years was small. Patients with fibrosis at MS had more major events, whereas patients with normal MS result had fewer major cardiac events, with higher survival.

Immunodiagnosis of Trypanosoma cruzi (Chagas' Disease) Infection in Naturally Infected Dogs

This study reports on the standardization of an enzyme-linked immunosorbent assay (ELISA) for detecting specific antibodies anti-Trypanosoma cruzi in naturally infected dogs. Sera from 182 mongrel dogs of all ages residing in four rural villages in Santiago del Estero, Argentina, were collected in November 1994 and preserved in buffered neutral glycerin. All sera were tested by indirect hemagglutination test (IHAT), indirect immunofluorescence test (IFAT), and ELISA using the flagellar fraction of T. cruzi as antigen. Dog sera from an area without vectorial transmission were used to calculate ELISA specificity and cut-off value. Eighty-six percent of sera had concordant results for all tests. All sera reactive for IHAT and IFAT were also reactive for ELISA, except in one case. Sera tested by ELISA when diluted 1:200 allowed a clearer division between non-reactive and reactive sera than when 1:100 with greater agreement among serologic techniques. The specificity of ELISA was 96.2%. Among 34 adult dogs with a positive xenodiagnosis, sensitivity was 94% both for ELISA and IFAT. ELISA is the first choice for screening purposes and one of the pair of techniques recommended for diagnostic studies in dog populations

Hepatic stereology of schistosomiasis mansoni infected-mice fed a high-fat diet

High-fat diets induce weight gain and fatty liver in wild-type mice. Schistosomiasis mansoni infection also promotes hepatic injury. This study was designed to quantify hepatic alterations in schistosomiasis mansoni-infected mice fed a high fat-rich chow compared to mice fed a standard rodent chow, using stereology. Female SW mice fed each either high-fat diet (29% lipids) or standard chow (12% lipids) over 8 months, and then were infected with Schistosoma mansoni cercariae. Four experimental groups were studied: infected mice fed a high-fat diet (IHFC) or standard chow (ISC), uninfected mice fed a high-fat diet (HFC) or standard chow (SC). Mice were sacrificed during early infection (9 weeks from exposure). The following hepatic biometry and the stereology parameters were determined: volume density (hepatocytes [h], sinusoids [s], steatosis [st] and hepatic fibrosis [hf]); numerical density (hepatocyte nuclei - Nv[h]); absolute number of total hepatocyte N[h], normal hepatocyte N[nh], and binucleated hepatocyte N[bh], percentage of normal hepatocyte P[nh] and binucleated hepatocyte P[bh]. IHFC and HFC groups exhibited TC, HDL-C, LDL-C, and body mass significantly greater (p < 0.05) than control group. No significant differences were found regards liver volume (p = 0.07). Significant differences were observed regards P[nh] (p = 0.0045), P[bh] (p = 0.0045), Nv[h] (p = 0.0006), N[h] (p = 0.0125), N[bh] (p = 0.0164) and N[nh] (p = 0.0078). IHFC mice group presented 29% of binucleated hepatocytes compared to HFC group (19%), ISC group (17%) and SC (6%). Volume density was significantly different between groups: Vv[h] (p = 0.0052), Vv[s] (p = 0.0025), Vv[st] (p = 0.0004), and Vv[hf] (p = 0.0007). In conclusion, schistosomiasis mansoni infection with concurrent high-fat diet promotes intensive quantitative changes in hepatic structure, contributing to an increasing on hepatic regeneration.

Histopathological examination of nerve samples from pure neural leprosy patients: obtaining maximum information to improve diagnostic efficiency

Nerve biopsy examination is an important auxiliary procedure for diagnosing pure neural leprosy (PNL). When acid-fast bacilli (AFB) are not detected in the nerve sample, the value of other nonspecific histological alterations should be considered along with pertinent clinical, electroneuromyographical and laboratory data (the detection of Mycobacterium leprae DNA with polymerase chain reaction and the detection of serum anti-phenolic glycolipid 1 antibodies) to support a possible or probable PNL diagnosis. Three hundred forty nerve samples [144 from PNL patients and 196 from patients with non-leprosy peripheral neuropathies (NLN)] were examined. Both AFB-negative and AFB-positive PNL samples had more frequent histopathological alterations (epithelioid granulomas, mononuclear infiltrates, fibrosis, perineurial and subperineurial oedema and decreased numbers of myelinated fibres) than the NLN group. Multivariate analysis revealed that independently, mononuclear infiltrate and perineurial fibrosis were more common in the PNL group and were able to correctly classify AFB-negative PNL samples. These results indicate that even in the absence of AFB, these histopathological nerve alterations may justify a PNL diagnosis when observed in conjunction with pertinent clinical, epidemiological and laboratory data.

Ruzigrass affecting soil-phosphorus availability

The objective of this work was to evaluate the effectiveness of ruzigrass (Urochloaruziziensis) in enhancing soil-P availability in areas fertilized with soluble or reactive rock phosphates. The area had been cropped for five years under no-till, in a system involving soybean, triticale/black-oat, and pearl millet. Previously to the five-year cultivation period, corrective phosphorus fertilization was applied once on soil surface, at 0.0 and 80 kg ha-1 P2O5, as triple superphosphate or Arad rock phosphate. After this five-year period, plots received the same corrective P fertilization as before and ruzigrass was introduced to the cropping system in the stead of the other cover crops. Soil samples were taken (0-10 cm) after ruzigrass cultivation and subjected to soil-P fractionation. Soybean was grown thereafter without P application to seed furrow. Phosphorus availability in plots with ruzigrass was compared to the ones with spontaneous vegetation for two years. Ruzigrass cultivation increased inorganic (resin-extracted) and organic (NaHCO3) soil P, as well as P concentration in soybean leaves, regardless of the P source. However, soybean yield did not increase significantly due to ruzigrass introduction to the cropping system. Soil-P availability did not differ between soluble and reactive P sources. Ruzigrass increases soil-P availability, especially where corrective P fertilization is performed.

Estresse oxidativo: relação entre geração de espécies reativas e defesa do organismo

This work describes the mechanism of action of some reactive oxygen species (ROS) and reactive nitrogen species (RNS) in the oxidative stress of the human body, and their consequences on damage to DNA, RNA, proteins and lipids. It also illustrates the defense system of our organism against these ROS and RNS species. The action of nonenzymatic protection systems is reported, with emphasis on micromolecules like Q10 coenzyme, vitamin C, alpha-tocopherol, carotenoids and flavonoids. The importance of flavonoids is also emphasized, and their body protection mechanism is detailed.

Preparação de carvão ativado em baixas temperaturas de carbonização a partir de rejeitos de café: utilização de FeCl3 como agente ativante

Ferric chloride as a new activating agent was used to obtain activated carbons from agroindustrial waste. This material was prepared at three temperatures of pyrolysis, 200, 280 and 400 ºC. The carbonaceous materials obtained after the activation processes showed high specific surface areas (BET), with values higher than 900 m² g-1. The materials showed different behaviors in the adsorption of methylene blue dye and reactive red textile dye in water solutions. An important fact in the use of FeCl3 as an activating agent is that the activation temperature is at 280 ºC, well below of those commonly employed in chemical or physical activations described in the literature.

Produção e caracterização de carvão ativado produzido a partir do defeito preto, verde, ardido (PVA) do café

The black, green and sour coffee defect (PVA) contributes with 20% of the total coffee production. It should be separate from the normal coffee grains in order to improve the final quality of the beverage. In this way, the present work has the objective to use the PVA reject for the production of activated carbon. The activated carbon (CA) was prepared from PVA defect using zinc chloride as activating agent. The prepared material (CA PVA) was characterized and the adsorption tests were carried out using as organic models methylene blue (AM) and reactive red (VR). The CA PVA revealed to be more efficient in the removal of the organic contaminants compared to a commercial activated carbon.

Cloreto de n-(2-hidroxil) propil-3-trimetil amônio quitosana como adsorvente de corantes reativos em solução aquosa

The quaternary chitosan was synthesized by reaction of chitosan with glycidyl trimethylammonium chloride. it was characterized by infrared spectra and conductometric titration. Adsorption of reactive blue 4 (RB4) and reactive red 120 (RR120) by quaternary chitosan was studied from aqueous medium. Two kinetic adsorption models were tested: pseudo first-order and pseudo second-order. The experimental data best fitted the pseudo second-order model. The Langmuir isotherm model provided the best fit to the equilibrium data in the concentration range investigated and the maximum adsorption capacity determined was 415 mg (RR120) and 637 mg (RB4) of reactive dye per gram of adsorbent.

Descoloração redutiva de corantes azo e o efeito de mediadores redox na presença do aceptor de elétrons sulfato

We investigated the impact of sulphate and the redox mediator Anthraquinone-2,6-disulfonate (AQDS) on the decolorization of the azo dyes Congo Red (CR) and Reactive Black 5 (RB5). In anaerobic reactors free of extra sulphate dosage, the color removal efficiency decreased drastically when the external electron donor ethanol was removed. In presence of an extra dosage of sulphate, CR decolourisations were 47.8% (free of AQDS) and 96.5% (supplemented with AQDS). The decolourisations achieved in both reactors with RB5 were lower than the ones found with CR. Finally, the biogenic sulphide contribution on azo dye reduction was negligiable.

Relações patofisiológicas entre estresse oxidativo e arteriosclerose

Oxidative stress is the result of an imbalance between oxidant and antioxidant species, with predominance of oxidative species with harmful action of reactive oxygen species (ROS) and reactive nitrogen species (RNS) on cells. Changes in the levels of nitric oxide (NO•) can be the cause and/ or a result of various pathophysiological processes. The main objective of this review is to address the relationship between oxidative stress and atherosclerosis in order to better understand the main features of this disease.

Metabolismo, oxidação e implicações biológicas do ácido docosahexaenoico em doenças neurodegenerativas

Docosahexaenoic acid (C22:6, n-3, DHA) is a polyunsaturated fatty acid (PUFA) present in large concentrations in the brain and, due to the presence of six double bonds in its structure, is highly susceptible to oxidation by enzymes and reactive oxygen/nitrogen species. The peroxidation of PUFAs has been implicated in an increasing number of human disorders, including neurodegenerative diseases. Hence, a better understanding of the metabolism pathways of DHA should provide new insights about its role in neurodegenerative diseases. Here we review the main aspects related to DHA metabolism, as well as, the recent findings showing its association with neurodegenerative diseases.

Descoloração de corantes industriais e efluentes têxteis simulados por peroxidase de nabo (Brassica campestre)

The removal of important textile dyes by turnip peroxidase (TNP) was evaluated. The textile effluents besides the residual dyes contain also chemical auxiliaries such as salts, dispersing and wetting agents. The effect of these was evaluated in the removal of the dyes reactive blue 21 and reactive blue 19 by TNP in synthetic effluents. A decrease of the efficency decolorization was observed. The action of the enzyme on colour removal of dye mixture was equivalent to the dyes alone. The chemical demand of oxygen in the effluent after enzymatic treatment had a significant increase in relation to the untreated effluent.

Results of surgical treatment of massive localized lymphedema in severely obese patients

OBJECTIVE: to evaluate the importance of treatment of deformities caused by massive localized lymphedema (MLL) in the severely obese. METHODS: in a period of seven years, nine patients with morbid obesity and a mean age of 33 years underwent surgical resection of massive localized lymphedema with primary synthesis. This is a retrospective study on the surgical technique, complication rates and improved quality of life. RESULTS: all patients reported significant improvement after surgery, with greater range of motion, ambulation with ease and more effective hygiene. Histological analysis demonstrated the existence of a chronic inflammatory process marked by lymphomonocitary infiltrate and severe tissue edema. We observed foci of necrosis, formation of microabscesses, points of suppuration and local fibrosis organization, and pachydermia. The lymphatic vessels and some blood capillaries were increased, depicting a framework of linfangiectasias. CONCLUSION: surgical treatment of MLL proved to be important for improving patients' quality of life, functionally rehabilitating them and optimizing multidisciplinary follow-up of morbid obesity, with satisfactory surgical results and acceptable complication rates, demonstrating the importance of treatment and awareness about the disease.