Incidence and Predictors of Cardiovascular Complications and Death after Vascular Surgery

AbstractBackground:Patients undergoing arterial vascular surgery are considered at increased risk for post-operative complications.Objective:To assess the incidence and predictors of complications and death, as well as the performance of two models of risk stratification, in vascular surgery.Methods:This study determined the incidence of cardiovascular complications and deaths within 30 days from surgery in adults. Univariate comparison and logistic regression assessed the risk factors associated with the outcomes, and the receiver operating characteristic (ROC) curve assessed the discriminatory capacity of the revised cardiac risk index (RCRI) and vascular study group of New England cardiac risk index (VSG-CRI).Results:141 patients (mean age, 66 years; 65% men) underwent the following surgeries: carotid (15); lower limbs (65); abdominal aorta (56); and others (5). Cardiovascular complications and death occurred within 30 days in 28 (19.9%) and 20 (14.2%) patients, respectively. The risk predictors were: age, obesity, stroke, poor functional capacity, altered scintigraphy, surgery of the aorta, and troponin change. The scores RCRI and VSG-CRI had area under the curve of 0.635 and 0.639 for early cardiovascular complications, and 0.562 and 0.610 for death in 30 days.Conclusion:In this small and selected group of patients undergoing arterial vascular surgery, the incidence of adverse events was elevated. The risk assessment indices RCRI and VSG-CRI did not perform well for complications within 30 days.

Observações sôbre a anestesia geral pelo hidrato de cloral na prática da cirurgia veterinária

In this paper the A. A. report the observations about the general anesthesia by chloral hydrate on the veterinary surgery. The observations were made on emasculation practices of horses, mules and hogs. It was possible to establish the following conclusions: 1) The choral hydrate presents low cost, it harmless, and is of easy application. 2) The more recommendable dosis for equine and swine were : 12-13 g per 100 k of body weight, in destilled water solution at 30 and 20%, respectively. 3) The anaethestic was injected by intravenous way with good results; in horses and mules the applications were made in the jugular; in swine, in the anterior vena cava, as was described by Carle and Dewhirst, because it was impracticable in the ear vein. 4) The dosis applied produced deep narcosis not lasting to long and with no danger to the animal's life. 5) In the case of fattening hogs, it must be made a discount of about 40% on the body weight, to calculate dosis to be employed. 6) The tables A and B show the results, that may be considered as good.

Competitive interactions between species of freshwater snails: I. Laboratory: Ia. General methodology

For the development of laboratory experiments on the competitive interacitons between freshwater snail populations, special snail rooms were set up in the main building of the Research Center "Aggeu Magalhães". In the current paper, the first of a series on this subject, the general methodology of the laboratory work is described in detail. Using indoor cement channels in which a uniform seminatural environment was created, interactions of freshwater snail populations can be studied with minimal interference of the usual variables. Controlled indoor environmental techniques, as described in the current paper, may also be utilized in different types of experiments in malacology, and represent a substantial technical advance in malacological work.

A surgery for American cuteneous and visceral leishmaniasis among 1,342 dogs from areas in Rio de Janeiro (Brazil) where the human diseases occur

There are areas in the periphery of Rio de Janeiro city where human cases of Visceral and/or Cutaneous Leishmaniasis occur. The parasites have been identified as Leishmania donovani and Leishmania braziliensis braziliensis respectively. A survey for Leishmaniasis was done among 1,342 dogs from those areas using an indirect immunofluorescent test. From the dogs, 616 came from areas where only human cases of Visceral Leishmaniasis occurred, 373 from an area where all human cases were of Cutaneous Leishmaniasis and 353 from a third area (Campo Grande) where both visceral and cutaneous human cases were detected. The prevalence of parasite antibody titers among dogs from areas of Cutaneous Leishmaniasis was significantly higher than that of Visceral Leishmaniasis (8.6% vs. 4.3%, p < 0.02). The highest prevalence was observed among dogs from the area where both diseases are present (12.7%).

Key to the species of Brazilian Procamallanus with general considerations (Nematoda, Camallanoidea)

In the present paper, the Peruvian Procamallanus (Spirocamallanus) incarocai (Freitas & Ibañez 1970) is proposed as a junior synonym of P. (S.) hilarii Vaz & Pereira, 1934. The validity of the subgenera Procamallanus Baylis, 1923 and Spirocammallanus Olsen, 1952 is discussed. a check list and a key to the species of Procamallanus Baylis, 1923 occuring in Brazil are presented.

Nematode parasites of Brazilian Ciconiiformes Birds: a general survey with new records for the species

This report deals with the identification of one hundred and fifty-nine samples of nematodes recovered from Brazilian egrets and herons. Contracaecum microcephalum, C. multipapillatum, C. plagiaticium, Desportesius invaginatus, D. longevaginatus, Desmidocercella ardeae, Eustrongylides ignotus, Porrocaecum reticulatum, Tetrameres micropenis, Capillaria sp., Contracaecum sp., Porrocaecum sp., Procyrnea sp., Tetrameres sp. and Viktorocara sp. were studied. The genus Viktorocara and the species C. microcephalum, C. plagiaticium, D. invaginatus, D. ardeae and P. reticulatum are referred in Brazil for the first time.

Nematode parasites of Brazilian piciformes birds: a general survey with description of Procyrnea anterovulvata n. sp. (Habronematoidea, Habronematidae)

Thirty species of nematodes recovered from Piciformes hosts are reported. Procyrnea anterovulvata n. sp. from Chelidoptera tenebrosa brasiliensis is described and compared to P. colaptes and P. pileata. The considered morphometric parameters are mainly related to the ratio between length of the body/distance of the vulva to the anterior end. It is approximately 1:0.5 in P. colaptes and P. pileata compared to 1:0.1 in the new species. The male of Synhimantus (Dispharynx) crassissima is described for the first time. Thelazia (Thelaziella) spizaeti is revalidated and new records are reported for some species.

Nematode Parasites of Brazilian Corvid Birds (Passeriformes): A General Survey with a Description of Viktorocara brasiliensis n. sp. (Acuariidae, Schistorophinae)

This report deals with the identification of 139 samples of nematodes recovered from Brazilian jays. Viktorocara brasiliensis n. sp. is proposed and compared with V. capillaris, V. limosae, V. charadrii and V. garridoi which are the other species included in the genus. The differentiation of V. brasiliensis n. sp. was based on the ratios between muscular and glandular esophagus and spicules, as well. Other referred species are Acuaria mamillaris, A. mayori, Aprocta sp., Cheilospirura sp., Diplotriaena americana, D. bargusinica, Oxyspirura matogrosensis, Oxyspirura sp., Pelecitus helicinus, Procyrnea sp., Skrjabinura spiralis, Subulura papillosa, Synhimantus sp. and Tetrameres (Microtetrameres) sp., with the establishment of some new host records

Frequency of CCR5 Delta-32 Mutation in Human Immunodeficiency Virus (HIV)-seropositive and HIV-exposed Seronegative Individuals and in General Population of Medellin, Colombia

Repeated exposure to human immunodeficiency virus (HIV) does not always result in seroconversion. Modifications in coreceptors for HIV entrance to target cells are one of the factors that block the infection. We studied the frequency of Delta-32 mutation in ccr5 gene in Medellin, Colombia. Two hundred and eighteen individuals distributed in three different groups were analyzed for Delta-32 mutation in ccr5 gene by polymerase chain reaction (PCR): 29 HIV seropositive (SP), 39 exposed seronegative (ESN) and 150 individuals as a general population sample (GPS). The frequency of the Delta-32 mutant allele was 3.8% for ESN, 2.7% for GPS and 1.7% for SP. Only one homozygous mutant genotype (Delta-32/Delta-32) was found among the ESN (2.6%). The heterozygous genotype (ccr5/Delta-32) was found in eight GPS (5.3%), in one SP (3.4%) and in one ESN (2.6%). The differences in the allelic and genotypic frequencies among the three groups were not statistically significant. A comparison between the expected and the observed genotypic frequencies showed that these frequencies were significantly different for the ESN group, which indirectly suggests a protective effect of the mutant genotype (Delta-32/Delta-32). Since this mutant genotype explained the resistance of infection in only one of our ESN persons, different mechanisms of protection must be playing a more important role in this population.

TT virus infection in children and adults who visited a general hospital in the south of Brazil for routine procedure

TT virus (TTV) is a newly described nonenveloped human virus, with a circular, negative-stranded DNA genome, that was first identified in the blood of a patient with posttransfusion hepatitis of unknown etiology. PCR primers and conditions used for TTV DNA amplification may greatly influence the level of TTV detection in serum. Three PCR assays, with different regions of the genome as targets, were used to test TTV DNA in 130 sera from children and adults visiting a hospital in the south of Brazil, most of them for routine procedure. Forty-four percent of adult sera and 73% of sera from children aged 0-10 years were TTV positive with at least one PCR assay. However, the three assays were able to detect only 33%, 35%, and 70% of the total positive samples. Our results showed a high prevalence of TTV infection in the south of Brazil, particularly among young children, and confirmed the necessity of performing several PCR assays to assess the true TTV prevalence in a determined population.

Clinical presentation and survival of smear-positive pulmonary tuberculosis patients of a University General Hospital in a developing country

From January 1995 to August 1997 we evaluated prospectively the clinical presentation, laboratory findings and short-term survival of smear-positive pulmonary tuberculosis (TB) patients who sought care at our hospital. After providing informed, written consent, the patients were interviewed and laboratory tests were performed. Information about survivorship and death was collected through September 1998. Eighty-six smear-positive pulmonary TB patients were enrolled; 26.7% were HIV-seropositive. Seventeen HIV-seronegative pulmonary TB patients (19.8%) presented chronic diseases in addition to TB. In the multiple logistic regression analysis a CD4+ cell count <= 200 cell/mm³ was independently associated with HIV seropositivity. In the Cox regression model, fitted to all patients, HIV seropositivity and age > or = 50 years were independently associated with decreased survival. Among HIV-seronegative persons, the presence of an additional disease increased the risk of death of almost six-fold. Use of antiretroviral drugs was associated with a lower risk of death among HIV-seropositive smear-positive pulmonary TB patients (RH = 0.32, 95% CI 0.10-0.92). In our study smear-positive pulmonary TB patients had a low short-term survival rate that was strongly associated with HIV infection, age and co-morbidities. Therapy with antiretroviral drugs reduced the short-term risk of death among HIV-seropositive patients after TB diagnosis.