Vasculites e eosinófilos em biópsia endomiocárdica, como preditores de rejeição em transplante cardíaco

FUNDAMENTO: O significado clínico de vasculites, lesões isquêmicas, efeito Quilty e da presença de eosinófilos em biópsias endomiocárdicas de receptores de transplante cardíaco com rejeições leves não foi ainda estabelecido. OBJETIVO: Verificar se esses achados histológicos encontrados nas biópsias endomiocárdicas (eosinófilos, vasculites, efeito Quilty e lesões isquêmicas) são capazes de predizer rejeição aguda do enxerto. MÉTODOS: Foram reavaliadas 1.012 biópsias endomiocárdicas consecutivas; dessas, 939 foram classificadas como OR ou 1R pela Nomenclatura da Sociedade Internacional de Transplante de Coração e Pulmão de 2005, e divididas em dois grupos: (1) Biópsias preditoras: aquelas que precederam rejeição aguda; e (2) Biópsias não preditoras: aquelas que não precederam rejeição aguda. Comparamos a ocorrência dos seguintes achados histológicos: vasculites, lesões isquêmicas, efeito Quilty e eosinófilos por análise uni e multivariada entre os grupos. RESULTADOS: Após análise estatística verificou-se a presença de vasculite intensa e de eosinófilos como maiores preditores para rejeição aguda futura, apresentando respectivamente as seguintes razões de chance: 10,60 (IC95%: 3,62 - 31,06. p < 0,001) e 6,26 (IC95%: 3,16 - 12,43. p < 0,001). CONCLUSÃO: Vasculites intensas e eosinófilos em biópsias do miocárdio são os principais fatores preditores de rejeição aguda pós-transplante cardíaco.

Fibrilação atrial e demência: resultados do São Paulo ageing & health study

FUNDAMENTO: A fibrilação atrial é um fator de risco controverso para demência. OBJETIVO: O objetivo deste estudo é avaliar a associação entre fibrilação atrial e demência em participantes do São Paulo Ageing & Health. MÉTODOS: O São Paulo Ageing & Health é um estudo transversal, de base populacional, de idosos residentes em um uma região de baixa renda da cidade de São Paulo, Brasil. Diagnóstico de demência foi realizado de acordo com o protocolo do grupo 10/66, com base em critérios do Manual de Diagnóstico e Estatística das Perturbações Mentais (DSM-IV). O diagnóstico de fibrilação atrial foi feito por eletrocardiograma de 12 derivações, avaliado por dois cardiologistas. Dados demográficos e de fatores de risco cardiovasculares também foram obtidos. RESULTADOS: A demência foi diagnosticada em 66 (4,3%) e fibrilação atrial em 36 (2,4%) de 1.524 participantes com um eletrocardiograma válido. A razão de chances bruta para demência em participantes com fibrilação atrial foi 2,8 (intervalo de confiança [IC] 95%: 1,0-8,1; p = 0,06) em comparação com indivíduos sem fibrilação atrial. Relação positiva foi encontrada em mulheres (RC 4,2; IC 95%: 1,2-15,1; p = 0,03). Após ajuste para idade, no entanto, essa associação tornou-se não significativa (RC 2,2, IC 95%: 0,6-8,9; p = 0,26). CONCLUSÃO: Não houve associação independente entre a fibrilação atrial e demência nessa amostra. A prevalência da fibrilação atrial pode ser baixa nesta população em virtude da mortalidade cardiovascular prematura.

A Comparison of Radiation Dose Between Standard and 3D Angiography in Congenital Heart Disease

Background: The use of three-dimensional rotational angiography (3D-RA) to assess patients with congenital heart diseases appears to be a promising technique despite the scarce literature available. Objectives: The objective of this study was to describe our initial experience with 3D-RA and to compare its radiation dose to that of standard two-dimensional angiography (2D-SA). Methods: Between September 2011 and April 2012, 18 patients underwent simultaneous 3D-RA and 2D-SA during diagnostic cardiac catheterization. Radiation dose was assessed using the dose-area-product (DAP). Results: The median patient age and weight were 12.5 years and 47.5 Kg, respectively. The median DAP of each 3D-RA acquisition was 1093µGy.m2 and 190µGy.m2 for each 2D-SA acquisition (p<0.01). In patients weighing more than 45Kg (n=7), this difference was attenuated but still significant (1525 µGy.m2 vs.413µGy.m2, p=0.01). No difference was found between one 3D-RA and three 2D-SA (1525µGy.m2 vs.1238 µGy.m2, p = 0.575) in this population. This difference was significantly higher in patients weighing less than 45Kg (n=9) (713µGy.m2 vs.81µGy.m2, P = 0.008), even when comparing one 3D-RA with three 2D-SA (242µGy.m2, respectively, p<0.008). 3D-RA was extremely useful for the assessment of conduits of univentricular hearts, tortuous branches of the pulmonary artery, and aorta relative to 2D-SA acquisitions. Conclusions: The radiation dose of 3D-RA used in our institution was higher than those previously reported in the literature and this difference was more evident in children. This type of assessment is of paramount importance when starting to perform 3D-RA.

Determinação quantitativa de putrescina por cromatografia em papel de filtro

O presente trabalho descreve o desenvolvimento de um método de determinação quantitativa da amina putrescina por cromatografia em papel de filtro seguida de espectrofotometria. 80-85% de putrescina adicionada a extratos de plantas pode ser recuperada. O espectro de absorção do produto de reação entre putrescina e ninhidrina tem um pico máximo a 575 mu. O desenvolvimento da côr do produto de reação atinge um máximo em 20 minutos, a 65ºC e se mantém estável durante os 10 minutos seguintes. O produto colorido eluido do cromatograma é estável durante 3 horas.

On the morphological "variation" on the aedaegus of Schizotetranychus oryzae (acari, prostigmata, tetranychidae)

Sobre a "variação" morfológica do edéago de Schizotetranychus oryzae (Acari, Prostigmata, Tetranychidae). Apresenta-se uma nota sobre a ocorrência do ácaro do arroz, Schizotetranychus oryzac Rossi de Simons, No Brasil, com observações sobre a "variação" morfológica do edéago do macho desta espécie de ácaro.

Efeito da deficiência de potássio sobre as atividades de glutamato desidrogenase e glutamato sintase em feijoeiro (Phaseolus vulgaris L.)

Foi estudado o efeito da deficiência de potássio sobre as atividades da glutamato desidrogenase (EC. 1.4.1.2) e glutamato sintase (EC. 2.6.1.53) em folhas de feijoeiro (Phaseolus vulgaris L.). Os resultados mostraram que a atividade específica da glutamato desidrogenase aumentou nas plantas deficientes em potássio nos dois cultivares estudados. Foi detectada redução na atividade de glutamato sintase nas plantas deficientes em potássio.

Ecologia populacional de Aegla franciscana (Crustacea, Decapoda, Anomura) em São Francisco de Paula, RS, Brasil

A pesquisa teve como objetivos caracterizar aspectos populacionais de Aegla franciscana Buckup & Rossi, 1977 que ocorre em corpos d'água do planalto sul-rio-grandense, onde foram analisados a distribuição de freqüência em classes de tamanho, a proporção sexual, o período reprodutivo através da freqüência de fêmeas ovígeras, o recrutamento e a fecundidade da espécie. As amostragens foram realizadas sazonalmente, no arroio Rolante, município de São Francisco de Paula, RS. Os eglídeos foram coletados com puçás, medidos e devolvidos ao arroio. Foram amostrados 1.322 exemplares, sendo 567 machos, 579 fêmeas e 176 animais com sexo indefinido. Machos e fêmeas foram agrupados em classes de comprimento do cefalotórax (CC), onde foi observada distribuição bimodal. A amplitude do comprimento do cefalotórax dos machos variou de 3,86 mm a 22,09 mm e o das fêmeas de 4,06 mm a 22,48 mm, sendo que os machos apresentaram tamanho mediano (10,36 mm) superior ao das fêmeas (9,89 mm). A proporção sexual foi de 1:1 (chi2 = 0,03; p>0,05). Na análise da proporção sexual, por classes de tamanho, observou-se que os machos são mais freqüentes nas classes superiores e as fêmeas nas classes intermediárias. O primeiro registro do surgimento de juvenis na população ocorreu no verão e de fêmeas ovígeras no outono, estas ocorrendo mais freqüentemente no inverno. As fêmeas ovígeras produzem em média 123,3 ± 47,8 ovos; observou-se correlação entre o comprimento do cefalotórax das fêmeas ovígeras e o número de ovos (r = 0,81).

V-region-related and -unrelated immunosupression accompanying infections

This paper discusses current evidence for the relationship between polyclonal lymphocyte activation, specific immunossupression with decreased resistance, and autoimmune pathology, that are all often found associated with infections by a variety of virus, bacteria and parasites . The central question of class determination of immune effector activities is considered in the context of the cellular targets for nonspecific mitogenic activities associated with infection. A model is presented to integrate these findings: mitogenens produced by the microorganism or the infected cells are preferentially active on CD5 B cells, the resulting over-production of IL-10 will tend to bias all immune activities in to a Th-2mode of effector functions, with high titers of polyclonal antibodies and litle or no production of gamma IFN and other "inflamatory"lymphokines that often mediate resistance. In turn these conditions allow for parasite persistence and the corresponding long-term disregulation of self-directed immune reactivities, resulting in autoimmunity in the chronic phase. This model would predict that selective immunization with the mitogenic principles involved in desregulation, could stand better chances than strategies of vaccination based on immunopotentiation against othere, functionally neutral antigenic epitopes. It is argued, however, that the complexity of immune responses and their regulation together with our ignorance on the genetic controls of class-determination, offer poor prospects for a scientifically-based, rational development of vaccines in the near future. It is suggested that empirically-based and technologically developed vaccines might suceed, while basic scientific approaches are reinforced and given the time provide a better understanding of those process.

Ecological Aspects of Phebotomine (Diptera, Psychodidae) in an Endemic Area of Tegumentary Leishmaniasis in the Northeastern Argentina, 1993-1998

The first epidemic tegumentary leishmaniasis´ outbreak in the province of Misiones was recorded in 1998, in the locality of Puerto Esperanza. Phlebotominae collected in the region, previously or simultaneously to the outbreak (September 1993-December 1998) showed that the species Lutzomyia intermedia s. l. was prevalent (94%, n 6,150) at all the sites sampled with miniature light trap (10) and Shannon trap (3). L. pessoai, L. whitmani, L. migonei, L. shannoni, L. fischeri, L. misionensis, Brumptomyia avellari and B. guimaraesi were also captured. Sand fly distribution in time and space suggests that in the province of Misiones (1) the species already present before 1990 could give rise to the epidemic by the density/dispersion fluctuation of their local populations; (2) the abundance of L. intermedia s. l. was associated with environments with ecotones of primary-secondary vegetation, close to water bodies and with moderate human disturbance; (3) this species showed, towards the end of 1997, peaks of exceptional abundance, subsequent to rainfall peaks in 1996. This increase in abundance of potential vector sand fly populations close to houses with colonizable surroundings could have generated the 1998 epidemic outbreak.

A First Record of Phlebotominae from Argentinean Patagonia (Diptera: Psychodidae: Phlebotominae)

A species of the Lutzomyia oswaldoi group is recorded from the Valcheta stream basin, Somuncura plateau, Patagonia. It represents the World southermost record of a species of Phlebotominae, apparently supporting the hypothesis about the relictual character of several components of the Somuncura plateau biota, particularly for those species belonging to the Paranaense lineages.

Larval dispersal and predation in experimental populations of Chrysomya albiceps and Cochliomyia macellaria (Diptera: Calliphoridae)

In this study we investigated the larval dispersal associated with larval predation in experimental populations of Chrysomya albiceps and Cochliomyia macellaria. Frequency distribution of sampling units (G test) in the substrate was used to evaluate variation in larval dispersal. An experimental acrylic channel (1 x 0.1 x 0.2 m) covered with wood shavings was used to observe larval dispersal prior to pupation. The acrylic channel was graduated at 0.05 m intervals, each representing a sampling unit; hence, 20 sampling units were set up. A Petri dish containing third instar larvae of single and double species was deposited at one edge of the acrylic channel allowing larvae to disperse. The number of buried pupae (0, 1, 2, …n) present in each sampling unit was recorded. For double species, the number of recovered larvae of C. albiceps was similar to the number initially released on the dish Petri. On the other hand, the number of recovered larvae of C. macellaria was significantly smaller than the initially released number. The results show that C. albiceps attacks C. macellaria larvae during the larval dispersal process. The larval distribution of C. albiceps did not differ significantly from C. macellaria in double species, but it differed significantly in single species. The larval aggregation level of C. macellaria decreased when C. albiceps was present and the larval aggregation level of C. albiceps increased when C. macellaria was present. The implications of such findings for the population dynamics of these species are discussed.

Phlebotominae sand flies in Paraguay: abundance distribution in the Southeastern region

From September 1993 to August 2001, 7,190 phlebotomine were collected with CDC light trap in an endemic area for human leishmaniasis, in the departments of Misiones and Itapúa, Paraguay. Eleven species were identified: Lutzomyia neivai (93.7%), L. whitmani (4.1%), and L. fischeri, L. shannoni, L. migonei, L. misionensis, L. cortelezzii, L. pessoai, L. alphabetica, Brumptomyia avellari and B. guimaraesi (less than 1%). The last three species are new records for the country. The biodiversity and phlebotomine abundance were associated with the proximity to primary forest or gallery forest, but L. neivai was also found in peridomestic periurban environment. L. neivai was found throughout the year, and showed a period of higher activity from September to April (spring to fall) with a unimodal or bimodal pattern in relation to the annual rainy peaks during the summer. Background literature about phlebotomine from Paraguay has been reviewed.

Nitric oxide and the resolution of inflammation: implications for atherosclerosis

The ubiquitous free radical, nitric oxide (NO), plays an important role in many biological processes including the regulation of the inflammatory response. Alterations in NO synthesis by endogenous systems likely influence inflammatory processes occurring in a wide range of diseases including many in the cardiovascular system (e.g. atherosclerosis). Progression of inflammatory conditions depends not only upon the recruitment and activation of inflammatory cells but also upon their subsequent removal from the inflammatory milieu. Apoptosis, or programmed cell death, is a fundamental process regulating inflammatory cell survival and is critically involved in ensuring the successful resolution of an inflammatory response. Apoptosis results in shutdown of secretory pathways and renders effete, but potentially highly histotoxic, cells instantly recognisable for non-inflammatory clearance by phagocytes (e.g., macrophages). However, dysregulation of apoptosis and phagocytic clearance mechanisms can have drastic consequences for development and resolution of inflammatory processes. In this review we highlight the complexities of NO-mediated regulation of inflammatory cell apoptosis and clearance by phagocytes and discuss the molecular mechanisms controlling these NO mediated effects. We believe that manipulation of pathways involving NO may have previously unrecognised therapeutic potential for limiting or resolving inflammatory and cardiovascular disease.