Exercise stress testing in healthy subjects during cholinergic stimulation after a single dose of pyridostigmine

OBJETIVE: The evaluation, by exercise stress testing, of the cardiorespiratory effects of pyridostigmine (PYR), a reversible acetylcholinesterase inhibitor. METHODS: A double-blind, randomized, cross-over, placebo-controlled comparison of hemodynamic and ventilation variables of 10 healthy subjects who underwent three exercise stress tests (the first for adaptation and determination of tolerance to exercise, the other two after administration of placebo or 45mg of PYR). RESULTS: Heart rate at rest was: 68±3 vs 68±3bpm before and after placebo, respectively (P=0.38); 70±2 vs 59±2bpm, before and after pyridostigmine, respectively (P<0.01). During exercise, relative to placebo: a significantly lower heart rate after PYR at, respectively, 20% (P=0.02), 40% (P=0.03), 80% (P=0.05) and 100% (P=0.02) of peak effort was observed. No significant differences were observed in arterial blood pressure, oxygen consumption at submaximal and maximal effort, exercise duration, respiratory ratio, CO2 production, ventilation threshold, minute ventilation, and oxygen pulse. CONCLUSION: Pyridostigmine, at a dose of 45mg, decreases heart rate at rest and during exercise, with minimal side effects and without interfering with exercise tolerance and ventilation variables.

Comparison between tilt-table testing results performed during different periods of the day

OBJECTIVE: To evaluate the influences of circadian variations on tilt-table testing (TTT) results by comparing the positivity rate of the test performed during the morning with that of the test performed in the afternoon and to evaluate the reproducibility of the results in different periods of the day. METHODS: One hundred twenty-three patients with recurrent unexplained syncope or near-syncope referred for TTT were randomized into 2 groups. In group I, 68 patients, TTT was performed first in the afternoon and then in the morning. In group II, 55 patients, the test was performed first in the morning and then in the afternoon. RESULTS: The TTT protocol was the prolonged passive test, without drug sensitization. Twenty-nine (23.5%) patients had a positive result in at least one of the periods. The positivity rate for each period was similar: 20 (16.2%) patients in the afternoon and 19 (15.4%) in the morning (p=1.000). Total reproducibility (positive/positive and negative/negative) was observed in 49 (89%) patients in group I and in 55 (81%) in group II. Reproducibility of the results was obtained in 94 (90.4%) patients with first negative tests but in 10 (34%) patients with first positive tests. CONCLUSION: TTT could be performed during any period of the day, and even in the 2 periods to enhance positivity. Considering the low reproducibility rate of the positive tests, serial TTT to evaluate therapeutic efficacy should be performed during the same period of the day.

Exercise testing in hypertensive patients taking different angiotensin-converting enzyme inhibitors

OBJECTIVE: To compare blood pressure response to dynamic exercise in hypertensive patients taking trandolapril or captopril. METHODS: We carried out a prospective, randomized, blinded study with 40 patients with primary hypertension and no other associated disease. The patients were divided into 2 groups (n=20), paired by age, sex, race, and body mass index, and underwent 2 symptom-limited exercise tests on a treadmill before and after 30 days of treatment with captopril (75 to 150 mg/day) or trandolapril (2 to 4 mg/day). RESULTS: The groups were similar prior to treatment (p<0.05), and both drugs reduced blood pressure at rest (p<0.001). During treatment, trandolapril caused a greater increase in functional capacity (+31%) than captopril (+17%; p=0.01) did, and provided better blood pressure control during exercise, observed as a reduction in the variation of systolic blood pressure/MET (trandolapril: 10.7±1.9 mmHg/U vs 7.4±1.2 mmHg/U, p=0.02; captopril: 9.1±1.4 mmHg/U vs 11.4±2.5 mmHg/U, p=0.35), a reduction in peak diastolic blood pressure (trandolapril: 116.8±3.1 mmHg vs 108.1±2.5 mmHg, p=0.003; captopril: 118.2±3.1 mmHg vs 115.8±3.3 mmHg, p=0.35), and a reduction in the interruption of the tests due to excessive elevation in blood pressure (trandolapril: 50% vs 15%, p=0.009; captopril: 50% vs 45%, p=0.32). CONCLUSION: Monotherapy with trandolapril is more effective than that with captopril to control blood pressure during exercise in hypertensive patients.

Safety, feasibility, and results of exercise testing for stratifying patients with chest pain in the emergency room

OBJECTIVE: To assess safety, feasibility, and the results of early exercise testing in patients with chest pain admitted to the emergency room of the chest pain unit, in whom acute myocardial infarction and high-risk unstable angina had been ruled out. METHODS: A study including 1060 consecutive patients with chest pain admitted to the emergency room of the chest pain unit was carried out. Of them, 677 (64%) patients were eligible for exercise testing, but only 268 (40%) underwent the test. RESULTS: The mean age of the patients studied was 51.7±12.1 years, and 188 (70%) were males. Twenty-eight (10%) patients had a previous history of coronary artery disease, 244 (91%) had a normal or unspecific electrocardiogram, and 150 (56%) underwent exercise testing within a 12-hour interval. The results of the exercise test in the latter group were as follows: 34 (13%) were positive, 191 (71%) were negative, and 43 (16%) were inconclusive. In the group of patients with a positive exercise test, 21 (62%) underwent coronary angiography, 11 underwent angioplasty, and 2 underwent myocardial revascularization. In a univariate analysis, type A/B chest pain (definitely/probably anginal) (p<0.0001), previous coronary artery disease (p<0.0001), and route 2 (patients at higher risk) correlated with a positive or inconclusive test (p<0.0001). CONCLUSION: In patients with chest pain and in whom acute myocardial infarction and high-risk unstable angina had been ruled out, the exercise test proved to be feasible, safe, and well tolerated.

Soluble ST2 Testing: A Promising Biomarker in the Management of Heart Failure

Abstract ST2 is a member of the interleukin-1 receptor family biomarker and circulating soluble ST2 concentrations are believed to reflect cardiovascular stress and fibrosis. Recent studies have demonstrated soluble ST2 to be a strong predictor of cardiovascular outcomes in both chronic and acute heart failure. It is a new biomarker that meets all required criteria for a useful biomarker. Of note, it adds information to natriuretic peptides (NPs) and some studies have shown it is even superior in terms of risk stratification. Since the introduction of NPs, this has been the most promising biomarker in the field of heart failure and might be particularly useful as therapy guide.

A disponibilidade do potássio da "leucita de Poços de Caldas", estudada por meio do arroz

In order to know potassium availability in "leucita de Poços de Caldas" from Poços de Caldas, Minas Gerais, a Mitscherlich pot experiment was set up. The pots were filled with 6 kilograms of sieved (4 mm) "Terra Roxa Misturada" soil. Rice (Oryza sativa, L.), Dourado Agulha variety was the testing plant. Doses of potassium referred to are 1,5 g (as K(2)0) from both KCl and "leucita de Poços de Caldas". There were 6 treatments, with 3 repetitions, as follows: 1) Control; 2) NP + 1 dose K (KCl); 3) NP + 2 doses K (KCl)); 4) NP + 3 doses K (KCl); 5) NP + 1 dose K (leucita); 6) NP + 2 doses K (leucita) and 7) NP + 3 doses K (leucita). Each pot received 50 seeds. Five days after germination the seedlings were thinned to 35. Harvesting took place 4 months after germination. Potassium (as KCl) promoted an increase in yield of both stalk and grain as compared with control. Potassium content in the leaves was also higher in all treatment in which KCl was supplied. Potassium, as "leucita de Poços de Caldas» did not show any favorable effect on both stalk and grain yield and on its content in the leaves.

Process of fixation, imobilization and mineralization of ammonium in soil using N-15

The organic and inorganic forms of soil nitrogen and how they participate in the process of fixation, immobilization and mineralization of ammonium in soils were evaluated, after different periods of incubaton, utilizing two soils, a Lithic Haplustoll and a Typic Eutrorthox. The results obtained permit to suggest that : 1) The method for determination of the ammonium fixing capacity based on the extraction with 2N KC1, is considered to be subject to interferences of other soil fractions capable of retaining ammonium. 2) The increase in exchangeable ammonium content is related to the decrease in amino acids and hydrolyzable ammonium. 3) The immobilization and mineralization processes are still held under mil microbial. The forms more affected by this condition are amino acids and hydrolyzable ammonium.

Doses and methods of distribution of potassium chloride on soybean crop (Glycine max (L.) Merrill) in a red latosol, affecting soil salinity, grain production and chemical composition of leaves

The present work deal t wi th an experiment under field conditions and a laboratory test of soil incubation the objectives were as follows: a. to study effects on soybean grain product ion and leaf composition of increasing doses of potassium chloride applied into the soil through two methods of distribution; b. to observe chemical modifications in the soils incubated with increasing doses of potassium chloride; and, c. to correlate field effects with chemical alterations observed in the incubation test, The field experiment was carried out in a Red Latosol (Haplustox) with soybean cultivar UFV - 1. Potassium chloride was distributed through two methods: banded (5 cm below and 5 cm aside of the seed line) and broadcasted and plowed-down. Doses used were: 0; 50; 100 and 200 kg/ha of K2O. Foliar samples were taken at flowering stage. Incubation test were made in plastic bags with 2 kg of air dried fine soil, taken from the arable layer of the field experiment, with the following doses of KC1 p,a. : 0; 50; 100; 200; 400; 800; 1,600; 3.200; 6,400 and 12,800 kg/ha of K(2)0. In the conditions observed during the present work, results allowed the following conclusions: A response by soybean grain production for doses of potassium chloride, applied in both ways, banded or broadcasted, was not observed. Leaf analysis did not show treatment influence over the leaf contents for N, P, K, Ca, Mg, and CI, Potassium chloride salinity effects in both methods of distribution for all the tested closes were not observed.

Increasing the efficiency of utilization of soil and fertilizer phosphorus in the subtropical and tropical agricultural systems C

As a rule, soils of the subtropical and tropical regions, in which rainfall is not limiting, are acidic, and low in phosphorus, and, to a less extent, in other macro and micronutrients as well, such a sulfur, boron and zinc. The establishment of a permanent agricultural prac. tice therefore, demands relatively high usage of liming and phosphatic fertilization, to begin with. Several approaches, not mutually exclusive, could be used in order to increase the efficiency of utilization of soil and fertilizer phosphorus so that, goal of diminishing costs of production is reached. The use of liming materials bringing up pH to 6.0-6.5 causes the conversion of iron and aluminum phosphates to more available calcium phosphates; on the other hand, by raising calcium saturation in the exchange complex, it improves the development and operation if the root system which allows c or a higher utilization of all soil nutrients, including phosphorus, and helps of stand water deficits which may occur. The role of mycorrhizal fungi should be considered as a way of increasing soil and fertilizer P utilization, as well as the limitations thereof. Screening of and breeding for varieties with higher efficiency of uptake and utilization of soil and fertilizer phosphorus leads to a reduction in cost of inputs and to higher benefit/cost ratios. Corrective fertilization using ground rock phosphate helps to saturate the fixation power of the soil thereby reducing, as a consequence, the need for phosphorus in the maintenance fertilization. Maintenance fertilization, in which soluble phos-phatic sources are used, could be improved by several means whose performance has been proved: limimg, granula tion, placement, use of magnesium salts. Last, cost of phosphate fertilization could be further reduced, without impairing yields, through impairing yields, through changes in technology designed to obtain products better adapted to local conditions and to the availability or raw materials and energy sources.

Soil invertebrates in southern Brazilian Araucaria forest - grassland mosaic: differences between disturbed and undisturbed areas

Soil invertebrate distribution in Araucaria forest, grassland and edge habitats was studied in both disturbed and undisturbed areas in southern Brazil. Mean-density and taxa compositions were verified. Invertebrate densities differed between grassland and the other two habitats in the undisturbed area but not across the disturbed one. At the disturbed area taxa differed between the grassland and the other two habitats. The undisturbed area, on the other hand, presented taxa differences only between the grassland and the forest habitats. Acari, Arachnida and Collembola were the most sensitive taxa for detecting differences across habitats in both areas. At the disturbed area, these taxa presented densities lowering from the forest to the grassland. At the undisturbed area the same taxa increased from the forest to the grassland. Coleoptera and Formicidae (Insecta) presented no difference between habitats at the studied taxonomic level.

The isolation of the perfect form of Microsporum Gypseum, Nannizzia Gypsea, Stockdale, 1963, from brazilian soil

Our work is on the isolation from brazilian soil of the perfect stage of Microsporum gypseum, Nannizzia gypsea, Stock., 1963, using cut sterilized children hair as bait.

A rapid method for testing in vivo the susceptibility of different strains of Trypanosoma cruzi to active chemotherapeutic agents

A method is described which permits to determine in vivo an in a short period of time (4-6 hours) the sensitivity of T. cruzo strains to known active chemotherapeutic agents. By using resistant- and sensitive T. cruzi stains a fairly good correlation was observed between the results obtained with this rapid method (which detects activity against the circulating blood forms) and those obtained with long-term schedules which involve drug adminstration for at least 20 consecutive days and a prolonged period of assessment. This method may be used to characterize susceptibility to active drugs used clinically, provide infomation on the specific action against circulating trypomastigotes and screen active compounds. Differences in the natural susceptibility of Trypanosoma cruzi strains to active drugs have been already reported using different criteria, mostly demanding long-term study of the animal (Hauschka, 1949; Bock, Gonnert & Haberkorn, 1969; Brener, Costa & Chiari, 1976; Andrade & Figueira, 1977; Schlemper, 1982). In this paper we report a method which detects in 4-6 hours the effect of drugs on bloodstream forms in mice with established T. cruzi infections. The results obtained with this method show a fairly good correlation with those obtained by prolonged treatment schedules used to assess the action of drugs in experimental Chagas' disease and may be used to study the sensitivity of T. cruzi strains to active drugs.