Effect of Nebivolol on MIBG Parameters and Exercise in Heart Failure with Normal Ejection Fraction

Abstract Background: More than 50% of the patients with heart failure have normal ejection fraction (HFNEF). Iodine-123 metaiodobenzylguanidine (123I-MIBG) scintigraphy and cardiopulmonary exercise test (CPET) are prognostic markers in HFNEF. Nebivolol is a beta-blocker with vasodilating properties. Objectives: To evaluate the impact of nebivolol therapy on CPET and123I-MIBG scintigraphic parameters in patients with HFNEF. Methods: Twenty-five patients underwent 123I-MIBG scintigraphy to determine the washout rate and early and late heart-to-mediastinum ratios. During the CPET, we analyzed the systolic blood pressure (SBP) response, heart rate (HR) during effort and recovery (HRR), and oxygen uptake (VO2). After the initial evaluation, we divided our cohort into control and intervention groups. We then started nebivolol and repeated the tests after 3 months. Results: After treatment, the intervention group showed improvement in rest SBP (149 mmHg [143.5-171 mmHg] versus 135 mmHg [125-151 mmHg, p = 0.016]), rest HR (78 bpm [65.5-84 bpm] versus 64.5 bpm [57.5-75.5 bpm, p = 0.028]), peak SBP (235 mmHg [216.5-249 mmHg] versus 198 mmHg [191-220.5 mmHg], p = 0.001), peak HR (124.5 bpm [115-142 bpm] versus 115 bpm [103.7-124 bpm], p= 0.043), HRR on the 1st minute (6.5 bpm [4.75-12.75 bpm] versus 14.5 bpm [6.7-22 bpm], p = 0.025) and HRR on the 2nd minute (15.5 bpm [13-21.75 bpm] versus 23.5 bpm [16-31.7 bpm], p = 0.005), but no change in peak VO2 and 123I-MIBG scintigraphic parameters. Conclusion: Despite a better control in SBP, HR during rest and exercise, and improvement in HRR, nebivolol failed to show a positive effect on peak VO2 and 123I-MIBG scintigraphic parameters. The lack of effect on adrenergic activity may be the cause of the lack of effect on functional capacity.

Extração de diversos íons do solo com solução normal de KCl

O presente trabalho tem por objetivo extrair e determinar diversos íons, como o alumínio, hidrogênio, cálcio e magnésio que se acham ligados aos colóides do solo por eletrovalência, em alguns solos do Município de Piracicaba. Além disso, constitui também finalidade dêste trabalho relacionar as diversas características dos solos estudados a fim de esclarecer vários aspectos considerados importantes na química do solo. Trinta e seis amostras de solos, correspondentes aos horizontes superficiais e subsuperficiais de dez séries do citado Município, foram submetidas à extração com solução 1 N de KCl e no extrato foram determinados os cátions já mencionados, além de determinar o pH em suspensão da solução 1 N em KCl. Nas mesmas amostras foram determinados: pH em suspensão aquosa, carbono total, cálcio, magnésio e potássio extraídos com solução 0,05 N de HNO3 e hidrogênio extraído com solução 1 N de acetato de cálcio com pH = 7,0. Os dados obtidos permitem concluir que a carga negativa permanente dos colóides dos solos estudados é muito baixa e que uma fração elevada da mesma é neutralizada pelo alumínio, em muitas das amostras analisadas. Verificou-se, também, que o teor de alumínio trocável correlaciona-se tanto com o pH determinado em suspensão aquosa, como com o determinado em suspensão de solução 1 N de CKl e com o hidrogênio, extraído com solução de acetato de cálcio 1 N com pH = 7,0. A porcentagem de saturação de bases, calculada em função da carga permanente e a calculada em função da extração das bases com solução de HNO3 0,05 N e da extração do hidrogênio com solução de acetato de cálcio 1N, pH = 7,0, correlacionam-se com o pH do solo. Finalmente, constatou-se que o teor de cálcio mais magnésio extraído com solução 1 N de KCl é equivalente ao extraído com solução 0,05 N de HNO3, indicando que, provàvelmente, os solos estudados não apresentam minerais silicatados ou carbonatados dos mencionados cátions.

Aplicação de reguladores de crescimento em figos produzidos fora da época normal

Fez-se a aplicação de giberelinas (50 e 100 ppm) e de clorofenoxipropionamida (250, 500 e 1000 ppm) sobre figos em vários estádios de desenvolvimento, de plantas podadas em dezembro, visando-se à produção de figos fora da época normal. Os resultados demostraram que as giberelinas a 50 ppm provocaram alongamento no comprimento dos figos. O tratamento com clorofenoxipropionamida (Fruitone CPA) a 1000 ppm resultou em frutos mais pesados, porém, estes valores não diferiram estatisticamente daqueles do tratamento controle. O peso médio dos figos foi de 50,0 gramas, para as primeiras oito semanas de colheita, período considerado no experimento.

Contribuição para a determinação do nível normal de componentes do sangue bovino canchim

Conduziu-se um experimento na Fazenda Canchim, em São Carlos, SP, para se verificar se determinados componentes do sangue de bovinos jovens refletiriam diferentes estados nutricionais. 0 delineamento estatístico foi o de blocos casualizados. Empregaram - se 36 bovinos canchim desmamados, inteiros, em regime de pasto exclusivo (T1), ou confinados, recebendo feno de soja e rolão de milho (T2), torta de algodão e cana-de-açúcar (T3), ou ração completa (T4), de março a setembro de 1973, e em seguida somente pasto, até março de 1974. No período de confinamento, as pesagens e coletas de sangue foram a cada 2 semanas, passando para 4no período seguinte. Embora os tratamentos houvessem proporcionado diferentes níveis de consumo, de ganho de peso e de conversão, não houve variação correspondente nos diversos componentes de sangue analisados, talvez porque os intervalos de coleta e de pesagens deveriam ter sido mais curtos, para que se relacionassem melhor, pois os primeiros dados corresponderam às médias diárias do intervalo entre pesagens, enquanto que as dosagens correspondiam a uma única determinação do dia da coleta. A utilização de "kits" para análise do sangue comprovou-se plenamente satisfatória, mais simples e rápida em relação ao sistema convencional. Foram assumidos como normais os níveis médios para os seguintes parâmetros do sangue: uréia, 11,1 a 16,1 mg;proteínas totais, 5,92 a 6,32 g; fósforo, 6,24 a 7,11 mg; Ca, 11,01 a 12,66 mg; e hemoglobina, 10,14 a 10,55 g por decilitro.

Lipoides do plasma normal

1. In a series of 21 normal cases we found for fatty acids per 100 cc. of plasma an average of 332 mgm., being 314 mgm. for the male sex and 350 mgm. for the female sex. 2.- For lecithin, in four normal cases we found per 100 cc. of plasma 182 mgm. estimated by the contents is phosphorus which ranged from 6.12 to 9.0 mgrs. 3.- Cholesterol in 20 normal cases showed 172 mgm. per 100 cc. of plasma. The averages were 151 mgm. for men and 194 mgm. for women. 4.- The readings of the fractions were 2.01 for the ratio fatty acids divided by lecithins 0.90 for lecithin divided by cholesterol and 1.93 for fatty acids divided by cholesterol. 5.- On comparing the results obtained by us with those reported in foreign literature an absolute conformity is noted chiefly with the values supplied by Bloor and Horiuchi for the ratios among the various lipoid fractions. The average for Cholesterol is comparable with that obtained by Myers but is slightly under that of Bloor's. The lecithin contents found by us did not reach such high values as those supplied by foreign authors.

Glutathion no sangue humano normal

1.) - Woodward-Fry's and Okuda-Hess technics were employed in the determination of blood glutathione in normal healthy adults of both sexes. 2.) - It was found more accurately results with the technic of Woodward and Fry than of any others for the dosage of G. S. H. of blood. 3.) - When the process of Okuda-Hess is modified by the use of an intern indicator (starch) the readings of the end-point are much more easy and therefore the results more exacts. 4.) - The averages of the data obtained for normal blood by the technic of Woodward and Fry were for men per hundred cubic cent. 27 mgrs (G.S.H); 6.6 mgrs. (G.S.S) and 33.6 mges. (G. T) and for women: 28.4 mgrs. (G.S.H), 7.8 mgrs. (G.S.S) and 36,2 mgrs. (G.T). 5.) - Autoxidation in the blood filtrate is only apreciated after 24 hs. In the first eight hours autoxidation is never observed. 6.) - The increase of glutathione in hyperglobulia is a function of the amount of red corpuscles. In acrocyanosis arterial blood is richest in these component than venous blood and this fact is in accordance with the observation of Blanchetière, Mélon and Binet for the experimental asphyxia of dogs.

Contribuição ao estudo do mal de cadeiras na Ilha de Marajó

Como resultado de inspeções feitas à ilha de Marajó o autor assinala: 1º) O mal de cadeiras continua existindo na ilha de Marajó sob a forma enzoótica, ao contrário do que pensavam os criadores, julgando-o extinto. As doenças designadas por estes como "barriga inchada" e "mormo seco", responsaveis pela grande mortalidade dos equinos, foram identificadas pelo autor como tal de cadeiras. 2º) O autor considera indispensável para a pesquisa do trypanosoma o processo de inoculação em animais de laboratório, tendo utilizado para esse fim camondongos e ratos brancos. 3º) Os surtos epizoóticos anuais coincidem com a época das chuvas, ocasião em que surgem os insetos hematófagos, o que faz pensar no papel desses últimos como transmissores. 4º) Os cavalos podem atravessar o ano com trypanosomas no sangue e em estado de saude aparente, constituindo assim depositários do mal de cadeiras. 5º) O extermínio da capivara, em consequência do seu aproveitamento econômico não modificou o carater endêmico da doença na ilha de Marajó. 6º) O autor observou que os trypanosomas no tubo digestivo de Stomoxys e Tabanideos, ao cabo de 8 horas, apresentavam com movimentos diminuidos e em formas arrendondadas, não conseguindo inoculações positivas com esse material. 7º) A saliva de um morcego do gênero Desmodus, que se infectou no laboratório, alimentando-se em animal doente, colhida de modo a evitar lesões da mucosa e consequente contaminação pelos trypanosomas do sangue circulante, mostrou-se incapaz de infectar, por inoculação, animais sensiveis. Este mesmo morcego não transmitiu a doença a um cão, o qual sugou durante 80 dias. Recentemente (1941) empregando um exemplar do gênero Desmodus, também infectado experimentalmente por alimentação em animal de laboratório, conseguimos transmitir o Trypanosoma equinum a uma cobaia normal. Este assunto será ventilado posteriormente.

Excreção urinária de 17-Cetoesteroides neutros no cavalo normal e no cavalo castrado

Total urinary neutral 17-steroids were determined in normal and in castrated horses. One liter of a 15-26 hours urine collection was hydrolysed by refluxing with 10% HC1 (v/v) for ten minutes and extracted with peroxyde-free ethyl ether. The extract was purified by washing with saturated NaHCO³ and KOH solutions. One half of the crude neutral fraction was fractionated with Girard's "T" reagent . The Zimmermann reaction was performed both in the ketonic and in the crude neutral extracts, using alcoholic 2.5N KOH and a 60 minutes period for the colour development in the dark. Optical density measuments were made in a grating Coleman Universal Spectrophotometer at 420 mµ and 520mµ; for the crude neutral fraction a colour correction equation was applied. The aliquot fraction used for colorimety was adjusted for keeping optical density measurements within the range 0.2 to 0.7. Androsterone (mp. 184-184.5°C) with an absorption maximum at 290.5 mµ (Beckman Model DU Spectrophotometer) was used as a reference standard. Table I, ilustrates the results obtained. At the 0.05 probability level there is a significant difference among castrated and normal group means (Fischer's "t" test.) when were used the data obtained from the ketonic fractions; in spite of the use of a colour correction applied for inespecific chromogens, the same results could not be obtained with the crude neutral fractions, Since Girard's reagent fractionation is generaly accepted as the best method for correcting the inespecific chromogen interference in the determination of the 17-ketosteroids by the Zimmermann reaction, we emphasize the value of the results obtained with the ketonic fractions. From these results it appears, as occurs in others mammals, that castrated horses show a lower level of urinary 17-ketosteroids excretion than the normal horses. The significance of the horse testis contribution for the neutral urinary steroid metabolites is discussed. Since horse urine has a low androgenic activity, the fractionation of the neutral 17-ketosteroids must be studied more accurately.

Hemograma do coelho normal e mixomatoso

O autor procurou estabelecer os dados relativos ao hemograma de coelho normal, do biotério do Instituto Oswaldo Cruz, encontrando as seguintes médias: hematias 5.186.000 por mm3, leucócitos 10.419 por mm3, e na contagem específica os seguintes valores para Heterófilos 40%, basófilos 2.5%, eosinófilos 0.2%, monócitos 6.5% e linfócitos 50%, e células de Tuerk 0.8%. Pode o autor confirmar o achado de AGOSIN, referente à presença de células morfológicamente semelhantes ás de TUERK, no sangue periférico dos coelhos normais. Realizou ainda, uma revisão bibliográfica do assunto.

Contribution to the normal fecal flora of the hamster: Proteus mirabilis in normal feces of hamster

Proteus mirabilis must be considered a normal inhabitant of the intestine of hamsters. It is also found in the vaginal secretion of females of this animal, when in oestrus.

Mitsuda's reactions: induced by BCG in the normal Rhesus ("Macacca mulatta")

The reversals of Mitsuda's reactions induced by BCG have been objected to based on the possiblem interference of other determination causes of the phenomenon: tuberculous primo-infections, communicants of unsuspected leprosy, revearsals due to other causes, such as anti-diphteric and anti-tetanic vaccination, etc. In order to study the problem, we have used Rhesus monkeys (Macaca mulatta), which were reared in isolation, in an attempt to avoid the referred to interferences. Prior to the experiments, all animals were tested and found negative to radiograph, tuberculin and lepromin tests and were then submitted to the application of BCG vaccine (from 1 to 3 days old), in different doses and by different via. At different times, after the application of BCG, they were again submitted to the radiographic, tuberculin and lepromin tests. In the tables I to IV the experiences were summarised. From the experiments, the following conclusions were reached: 1 - From 12 Rhesus that received BCG 11 showed reversals of the Mitsuda reaction (91.7%). 2 - These reverseals took place both in tests effected shortly after BCG (from 6 days to 2 months), and tests effected much later (from 7 to 12 months after BCG). 3 - Some differences were found in the results, according to the dosis and the application via of the BCG. a) - The testicular and peritonela via (0,02g) were the only that determined strong positive Mitsuda's reactions (+++). b) - By oral via, animals that received high dosis (0.6g and 1.2 g), there resulted uniform and regular reversals, even though of low intensity (+); but from those who got small doses (0.2 g.) one showed no reversals in all tests, and the other presented reversals in the 2nd and 3rd tests only, also with low positivity (+). 4) In the 2nd and 3rd Mitsuda's reactions in the same animals, positivity was always precocious (generally within 48 hours), one getting the impression that there occurs a sensibilization of the animal body by the antigen with the repetition of the tests, even though the intensity of the reaction always remains the same. This precocious reaction (Fernandez type) occurs both shortly and long time after the application of the BCG. Its precocity depends not of the antigen only because the first Mitsuda's reaction after the BCG application occurs after some time and seems not influenced by the control lepromin test effected on the Rhesus before the BCG. 5) On the control group, the animals which received a.a.f. bacilli suspensions (Mycobacterium sp.; M. avium, and M. smegmatis), did not show reverseals of the Mitsuda's reaction. Two Rhesus, however, which received dead BCG (120ºC autoclave 1 hour), one intradermically (0.006 g) and the other orally (1.2 g), did both present reversals of the Mitsuda's reaction, with weak positivity (+). In all animals of the control-group, the allergic reactions were found negative. 6) Strong local inflammatory reactions were observed in the Rhesus that had received living BCG by intradermal via, and in the one submitted to multipunctures, there occurred the formation of a large caseous abcess. 7) The allergic tuberculinic and infratuberculinic reactions appeared dissociated from the Mitsuda's reactions: sometimes they are more precocious, occurring before of the lepromin test; on other occasions they disappear, when the Mitsuda's reactions still persist; and finally, they may be absent, when the latter occur, especially after the oral application of the BCG. 8) In Rhesus which received BCG by testicular and peritonela via, in the infratuberculinic test (0.1 ml of total BCG extract), besides the classic answer, which occurs between 48 and 96 hours, one could observe a delayed answer (15 to 20 days), represented by a non-erythematous nodule, which persists for 11-14 days.

A study of the endocervical columnar cells II - effects of physiological changes and of oathological lesions of the uterus on the specific numerical composition of the endocervical epithelium

In the second part of this paper we nalysed the correlation between the clinical pathological alterations and the sum of the types of columnar cells of 300 histological sections of cervix. Fifty histological sections of normal cervix of sexually mature women were selected and considered as normal in pattern. The specific counts of the columnar cells which line the endocervical mucosa and those of the glands of 50 normal cervices were compared with other similar counts made in 50 histological sections of cervices of old women and emphasized the differences. Comparisons were made also between 50 normal cervices and 50 sections of cervices with chronic inflammation, 50 cervices with epidermoid metaplasia and 50 cervices with myoma of the corpus. Counts were made from 50 cervices of patients who on the occasion of the surgical operation were in the proliferative phase of the menstrual cycle; these were compared with the counts of 50 cervices of uteri in the luteal phase. Finally, the numerical frequency of the following data encountered in the 300 cervices was recorded: 1. aspects of the ectocervical epithelium; 2. number of Nabothian cysts; 3. number of cervical glands; 5. number of deliveries and 6. aspect of the material within the cervical canal.