I Brazilian Registry of Heart Failure - Clinical Aspects, Care Quality and Hospitalization Outcomes

Background:Heart failure (HF) is one of the leading causes of hospitalization in adults in Brazil. However, most of the available data is limited to unicenter registries. The BREATHE registry is the first to include a large sample of hospitalized patients with decompensated HF from different regions in Brazil.Objective:Describe the clinical characteristics, treatment and prognosis of hospitalized patients admitted with acute HF.Methods:Observational registry study with longitudinal follow-up. The eligibility criteria included patients older than 18 years with a definitive diagnosis of HF, admitted to public or private hospitals. Assessed outcomes included the causes of decompensation, use of medications, care quality indicators, hemodynamic profile and intrahospital events.Results:A total of 1,263 patients (64±16 years, 60% women) were included from 51 centers from different regions in Brazil. The most common comorbidities were hypertension (70.8%), dyslipidemia (36.7%) and diabetes (34%). Around 40% of the patients had normal left ventricular systolic function and most were admitted with a wet-warm clinical-hemodynamic profile. Vasodilators and intravenous inotropes were used in less than 15% of the studied cohort. Care quality indicators based on hospital discharge recommendations were reached in less than 65% of the patients. Intrahospital mortality affected 12.6% of all patients included.Conclusion:The BREATHE study demonstrated the high intrahospital mortality of patients admitted with acute HF in Brazil, in addition to the low rate of prescription of drugs based on evidence.

Depression as a Clinical Determinant of Dependence and Low Quality of Life in Elderly Patients with Cardiovascular Disease

Background:The aging process promotes a progressive increase in chronic-degenerative diseases. The effect of these diseases on the functional capacity has been well recognized. Another health parameter concerns “quality of life related to health”. Among the elderly population, cardiovascular diseases stand out due to the epidemiological and clinical impact. Usually, these diseases have been associated with others. This set of problems may compromise both independence and quality of life in elderly patients who seek cardiologic treatment. These health parameters have not been well contemplated by cardiologists.Objective:Evaluating, among the elderly population with cardiovascular disease, which are the most relevant clinical determinants regarding dependence and quality of life.Methods:This group was randomly and consecutively selected and four questionnaires were applied: HAQ, SF-36, PRIME-MD e Mini Mental State.Results:The study included 1,020 elderly patients, 63.3% women. The group had been between 60 and 97 years-old (mean: 75.56 ± 6.62 years-old). 61.4% were independent or mild dependence. The quality of life total score was high (HAQ: 88.66 ± 2.68). 87.8% of patients had a SF-36 total score > 66. In the multivariate analysis, the association between diagnoses and high degrees of dependence was significant only for previous stroke (p = 0.014), obesity (p < 0.001), lack of physical activity (p = 0.016), osteoarthritis (p < 0.001), cognitive impairment (p < 0.001), and major depression (p < 0.001). Analyzing the quality of life, major depression and physical illness for depression was significantly associated with all domains of the SF-36.Conclusion:Among an elderly outpatient cardiology population, dependence and quality of life clinical determinants are not cardiovascular comorbidities, especially the depression.

Reproducibility and Reliability of the Quality of Life Questionnaire in Patients With Atrial Fibrillation

Abstract Background: Studies have shown the impact of atrial fibrillation (AF) on the patients' quality of life. Specific questionnaires enable the evaluation of relevant events. We previously developed a questionnaire to assess the quality of life of patients with AF (AFQLQ version 1), which was reviewed in this study, and new domains were added. Objective: To demonstrate the reproducibility of the AFQLQ version 2 (AFQLQ v.2), which included the domains of fatigue, illness perception and well-being. Methods: We applied 160 questionnaires (AFQLQ v.2 and SF-36) to 40 patients, at baseline and 15 days after, to measure inter- and intraobserver reproducibility. The analysis of quality of life stability was determined by test-retest, applying the Bartko intraclass correlation coefficient (ICC). Internal consistency was assessed by Cronbach's alpha test. Results: The total score of the test-retest (n = 40) had an ICC of 0.98 in the AFQLQ v.2, and of 0.94 in the SF36. In assessing the intra- and interobserver reproducibility of the AFQLQ v.2, the ICC reliability was 0.98 and 0.97, respectively. The internal consistency had a Cronbach's alpha coefficient of 0.82, compatible with good agreement of the AFQLQ v.2. Conclusion: The AFQLQ v.2 performed better than its previous version. Similarly, the domains added contributed to make it more comprehensive and robust to assess the quality of life of patients with AF.

Host plants of root-knot nematodes

Root-knot nematodes were found attacking Coffea spp. and also roots of a few weed species usually found in the coffee orchards in São Paulo. C. arabica cv. Catuaí, C. arabica cv. Mundo Novo, Timor Hybrid and a few plants of C. racemosa showed to be susceptible to Meloidogyne exigua. Roots of Ageratum conyzoides, Amaranthus viridis, Bidens pilosa, Coffea arabica cv. Mundo Novo, Coffea racemosa, Commelina virginica, Digitaria sanguinalis, Galinsoga parviflora, Gnaphalium spathulatum, Porophyllum ruderale, Portulaca oleracea, Pterocaulon virgatum and Solanum americanum were disfigured by M. incognita M. arenaria was found attacking roots of Eleusine indica and Gnaphalium spathulatum, and the presence of an unidentified Meloidogyne species was verified in roots of the following species: Vernonia ferruginea, C. arabica x C. canephora, Eupatorium pauciflorum, Coffea canephora cv. Kouillou, Coffea eugenioides, Coffea racemosa, Coffea stenophylla, Euphorbia pilullifera, Solanum americanum, Ageratum conyzoides, Phyllanthus corcovadensis, and Emilia sagittata.

Production and quality of cotton fibers in relation to solar radiation

The present paper refers to a research work carried out at the Dept. of Agriculture and Horticulture of ESALQ, University of São Paulo, in Piracicaba, State of São Paulo (latitude 22º42'S, longitude 47º33' WG and altitude 546 m). Sowing at different times and using artificial cover, an attempt was made to evaluate the behavior of cultivar IAC 17 of cotton (Gossypium hirsutum L.) as to production and quality of fiber relating to incident solar radiation. Incident solar radiation, as well as insolation during the trial period, were tabulated and compared with yelds and agricultural and technological characters of fibers. The treatment under cover showed a mean level of incident solar radiation equivalent to less than 20% of that at clear sky, causing a decrease in cotton production and in the agricultural and technological characters of fibers.

Effects of environment on quality of tomato transplanting plants

In order to study the effects of shading and unshading combined with N fertilizing on tomato transplanting plants, an experiment in greenhouse conditions was carried on. It was concluded that N is important to produce healthy and strong plants. Under shading plus N fertilization, plants are taller and have high nitrate contents, while under unshading plus N fertilization, plants have higher diameter and more developed root system.

Stink bugs (Heteroptera, Pentatomidae) and an unique host plant in the Brazilian subtropics

Stink bugs are seed/fruit sucking insects feeding on an array of host plants. Among them, an exotic tree called privet, Ligustrum lucidum Ait. (Oleaceae), is very common in the urban areas of the Brazilian subtropics, where it is utilized as food source and shelter for over a decem species of bugs, year round. The species composition, their performance and abundance on this host, and possible causes for this association are discussed and illustrated.

Oviposition behavior of Zabrotes subfasciatus females (Coleoptera, Bruchidae) under conditions of host deprivation

Oviposition of Zabrotes subfasciatus (Boheman, 1833) on Phaseolus vulgaris (Linnaeus, 1753) was studied immediately after emergence of the adults throughout the females life and in situations of host deprivation lasting for 1 to 10 days. The number of eggs laid daily, longevity, duration of oviposition and distribution of eggs per grain were studied. The number of eggs laid per day varied significantly, with the oviposition peak in the presence of the host (control group) occurring between day 2 and day 5 of oviposition. In the absence of the host, a shift in the oviposition peak to the first day after deprivation was observed, except for the group deprived for one day which showed a peak between days 1 and 4 after introduction of the host. The distribution of the eggs per grain in the control group and in the groups deprived of the host for 2, 5, 8 and 10 days, a larger egg aggregation was observed for all deprived groups compared to the control group.

Oviposition behavior of wild Zabrotes subfasciatus (Coleoptera, Chrysomelidae) females deprived of the host Phaseolus vulgaris (Fabaceae)

The insects oviposition behavior is fundamental to study population dynamics, life history evolution, insect-plant and parasitoid-host interactions. Zabrotes subfasciatus (Boheman, 1833) females oviposition behavior in the presence and absence of a host is unknown. The main objective of this study was to describe in detail the oviposition behavior of host deprived or non-deprived females, and observe how the several situations of deprivation (days without host) influence oviposition. Six groups were assembled, three deprived of the host (for 2, 5 and 8 days) and three control groups (with host), each containing one newly-emerged couple (0-24h) of wild Z. subfasciatus, The non-deprived (control) groups received the hosts every day (5 bean seeds Phaseolus vulgaris (Fabaceae)) and the others were deprived for 2, 5 and 8 days, respectively. For each group 12 repetitions were made. Consequently, 12 couples were host deprived during two days, 12 couples were host deprived during five days and 12 couples were host deprived during eight days. When the seeds of the deprived groups were added the experiments started. There was a control group for each deprived group. The experiments and the insects were maintained at constant temperature 29 ± 2ºC and 70-80% relative humidity. At 15 minutes interval, the number of times the females manifested the different categories of behavior was observed (frequency). The behavior categories were: rest inside the box, locomotion, resource exploration (seeds), copulation and oviposition. The deprived females stayed most of the time in contact with the host to carry out oviposition, while the non-deprived (control) females spent most of the time at rest. This was observed in all the deprivation times. The results show that host deprivation influences the oviposition behavior of the studied species and also shows the flexibility in the oviposition strategies that these females present when the environment changes (absence and presence of resources)

Benthic macroinvertebrates as bioindicators of water quality in an Atlantic forest fragment

The objective of this study was to evaluate benthic macroinvertebrate communities as bioindicators of water quality in five streams located in the "Reserva Particular do Patrimônio Natural" (RPPN) Mata Samuel de Paula and its surroundings, in the municipality of Nova Lima near the city of Belo Horizonte, Minas Gerais State, southeastern Brazil. This region has been strongly modified by human activities including mining and urbanization. Samples were collected in the field every three months between August 2004 and November 2005, totaling six samplings in the rainy and dry seasons. This assessment identified one area ecologically altered while the other sampling sites were found to be minimally disturbed systems, with well-preserved ecological conditions. However, according to the Biological Monitoring Work Party (BMWP) and the Average Score Per Taxon (ASPT) indices, all sampling sites had excellent water quality. A total of 14,952 organisms was collected, belonging to 155 taxa (148 Insecta, two Annelida, one Bivalvia, one Decapoda, one Planariidae, one Hydracarina, and one Entognatha). The most abundant benthic groups were Chironomidae (47.9%), Simuliidae (12.3%), Bivalvia (7.5%), Decapoda (6.1%), Oligochaeta (5.2%), Polycentropodidae (3.7%), Hydropsychidae (2.5%), Calamoceratidae (1.8%), Ceratopogonidae (1.7%), and Libellulidae (1.2%). The assessment of the benthic functional feeding groups showed that 34% of the macroinvertebrates were collector-gatherers, 29% predators, 24% collector-filterers, 8% shredders, and 5% scrapers. The RPPN Mata Samuel de Paula comprises diversified freshwater habitats that are of great importance for the conservation of many benthic taxa that are intolerant to organic pollution.

The principal reservoir host of cutaneous leishmaniasis in the urban areas of Manaus, Central Amazon of Brazil

Twenty one opossums (Didelphis marsupialis) from disturbed primary forest in the vicinity of Manaus, and seven from an isolated island of secondary vegetation within the city of Manaus, were examined for the presence of Leishmania. Of the opossums from the primary forests, 13 (61.9%) were found to be positive for Leishmania braziliensis guyanenesis. One additional opossum was found to be positive for Le. mexicana amazonensis. A simple and economical trapping technique for opossums is presented here, and a control method in special cases is suggested.

Host factors influencing outcome of Leishmania mexicana infection in mice

Studies were undertaken to determine the influence of several host-related parameters on the course of Leishmania mexicana mexicana infection in inbred C57B1/10 (C57) and outbred albino (OA) mice. An important influence of the following variables was demonstrated: Host strain: lesions in C57s were significantly less variable in size and outcome than those of OAs under the conditions studied and even when persistent developed at a slower rate. Host age: Subcutanous injection of 2 x 10 [raised to the power of 4] to 2 x 10 [raised to the power of 6] amastigotes into the dorsum of the rear paw produced significantly larger lesions which healed more slowly in 2 mo. old C57s than in 4 mo. old mice. Reduced healing ability was observed in older (8 mo. old) female C57s, and low mortality occurred after 15 months of age in infected mice of both sexes. Lesion site: Following amastigote infection, lesions in paws of most C57s regress within 15 - 25 wks. In contrast, perinasal legions produced with the same number of parasites tend to persist for the life of the animal as slowly spreading irregular nodules. In animals infected in both locations, each lesion site behaves similarly to that in singly infected animals of the same age, i.e. regression in the two sites is independent. Our results indicate that while host strain may strongly influence infection outcoem, such variables as lesion site and host age play important roles and may explain, in part, reported inter- and intraexperimental variability in responses of murine hosts to a given leishmanial parasite.

New Host, geographical record and a synonym for Phyllodistomum Spatula Odhner, 1902 (Trematoda, Gorgoderidae)

In the present note Phyllodistomum spatula Odhner, 1902 is recorded for the first time from Brazil and in a New host Colossoma macropomum (Cuvier, 1818) (Pisces, serrasalmidae), and Plyllodistomum spatulaeforme Odhner, 1902 is considered its synonym.

Philander opossum (Marsupialia), a new host record for Sparganum of Lueheella Baer, 1924 (= Spirometra Mueller, 1937)

Two samples of Sparganum, the larval form of Lueheella Baer, 1924 (= Spirometra Mueller, 1937) were recovered from Philander opossum (L. 1758) captured in Salobra, Mato Grosso State, Brazil, by Dr. Lauro Travassos in may, 1942. This is the first report of the presence of this larval form in P. opossum. Dealing with helminths recovered from Brazilian Marsupialia, deposited in Oswaldo Cruz Institute Helminthological Collection, we examined in two samples of the preserved material collected in Salobra. Mato Grosso State, nine larval forms (Sparganum) of Lueheella sp. One of the samples, with six specimens, tissue. It is the first report of philander opossum harbouring this larval stage. The studied preserved wet material was stained and whole mounts were deposited in the Oswaldo Cruz institute Helminthological collection ns. 31.470 and 31.471. Measurements are in mm.

Trypanosoma cruzi: vertebrate and invertebrate cycles in the same mammal host, the opossum Didelphis marsupialis

Epimastigotes multiplying extracellularly and metacyclic trypomastigotes, stages that correspond to the cycle of Trypanosoma cruzi in the intestinal lumen of its insect vector, were consistently found in the lumen of the anal glands of opossums Didelphis marsupialis inoculated subcutaneously with infective feces of triatomid bugs.