Relação entre a persistência da condução pela via lenta nodal após ablação de taquicardia por reentrada nodal e a recorrência clínica

OBJETIVO: Verificar se a persistência de salto nodal relaciona-se à taxa de recorrência de taquicardia por reentrada nodal (TRN) após ablação com radiofreqüência (RF) da via lenta do nó atrioventricular. MÉTODOS: Num seguimento de 20±12 meses, foi analisada a recorrência de TRN em 126 pacientes consecutivos submetidos a ablação com RF da via lenta nodal. O critério de interrupção do procedimento foi a não reindução da TRN, após estimulação atrial programada, com e sem isoproterenol intravenoso. Ao final do procedimento, 98 pacientes não apresentavam salto nodal, e em 28 persistia o salto nodal e/ou o eco atrial. RESULTADOS: Houve recorrência clínica de TRN em 15 (11%) pacientes: 9 no grupo sem salto nodal e/ou eco atrial e em 6 do grupo que persistiu com salto e/ou eco atrial. A recorrência tendeu a ser maior no 2º grupo (9% vs 21%), mas não houve significância estatística entre os resultados (p=0,09). CONCLUSÃO: Desde que a TRN não possa ser induzida após a infusão de isoproterenol, a recorrência espontânea da arritmia após a ablação por RF da via lenta nodal não é diferente entre pacientes que persistem ou não com salto nodal e/ou eco atrial.

Aortic stenosis. Gender influence on left ventricular geometry and function in patients under 70 years of age

OBJECTIVE: To verify if adaptive left ventricle (LV) characteristics are also present in individuals under 70 years of age with severe aortic stenosis (AS). METHODS: The study comprised 40 consecutive patients under 70 years of age with AS and no associated coronary artery disease, referred for valve surgery. Out of the 40 patients, 22 were men and 18 women, and the mean age was 49.8±14.3 years. Cardiac symptoms, presence of systemic hypertension (SH), functional class according to the New York Heart Association (NYHA), and valve lesion etiology were considered. LV cavity dimensions, ejection fraction (EF), fractional shortening (FS), mass (MS), and relative diastolic thickness (RDT) were examined by Doppler echocardiography. RESULTS: Fourteen (63.6%) men and 11 (61.6%) women were classified as NYHA class III/IV (p=0.70). There was no difference in the frequency of angina, syncope or dyspnea between genders. The incidence of SH was greater in women than in men (10 versus 2, p=0.0044). Women had a smaller LV end-diastolic diameter index (32.1±6.5 x 36.5±5.3mm/m², p=0.027), LV end-systolic diameter index (19.9±5.9 x 26.5±6.4mm/m², p=0.0022) and LV mass index (MS) (211.4±71.1 x 270.9±74.9g/m², p=0.017) when compared with men. EF (66.2±13.4 x 52.0±14.6%, p=0.0032), FS (37.6±10.7 x 27.9±9.6%, p=0.0046) and RDT (0.58±0.22 x 0.44±0.09, p=0.0095) were significantly greater in women than in men. CONCLUSION: It is the patient gender rather than age that influences left ventricular adaptive response to AS.

Left Ventricular Diastolic Function in Essential Hypertensive Patients: Influence of Age and Left Ventricular Geometry

PURPOSE - To evaluate diastolic dysfunction (DD) in essential hypertension and the influence of age and cardiac geometry on this parameter. METHODS - Four hundred sixty essential hypertensive patients (HT) underwent Doppler echocardiography to obtain E/A wave ratio (E/A), atrial deceleration time (ADT), and isovolumetric relaxation time (IRT). All patients were grouped according to cardiac geometric patterns (NG - normal geometry; CR - concentric remodeling; CH- concentric hypertrophy; EH - eccentric hypertrophy) and to age (<40; 40 - 60; >60 years). One hundred six normotensives (NT) persons were also evaluated. RESULTS - A worsening of diastolic function in the HT compared with the NT, including HT with NG (E/A: NT - 1.38±0.03 vs HT - 1.27±0.02, p<0.01), was observed. A higher prevalence of DD occurred parallel to age and cardiac geometry also in the prehypertrophic groups (CR). Multiple regression analysis identified age as the most important predictor of DD (r²=0.30, p<0.01). CONCLUSION - DD was prevalent in this hypertensive population, being highly affected by age and less by heart structural parameters. DD is observed in incipient stages of hypertensive heart disease, and thus its early detection may help in the risk stratification of hypertensive patients.

Contribuição da análise eletrofisiológica e anatômica do circuito atípico da taquicardia atrioventricular nodal

OBJETIVOS: Analisar a condução retrógrada durante os episódios de ritmo juncional ectópico acelerado (JET) e avaliar a existência da relação entre a presença de um bloqueio retrógrado e o risco de desenvolvimento de bloqueio atrioventricular (BAV) durante os procedimentos de ablação por radiofreqüência de pacientes portadores de taquicardia atrioventricular nodal (TAVN). MÉTODOS: Foram 145 pacientes portadores de TAVN, de ambos os sexos, com 16 a 84 anos submetidos à ablação com cateter de radiofreqüência na região póstero-septal do átrio direito. Critérios avaliados: localização anatômica e comportamento eletrofisiológico da condução retrógrada durante TAVN (definindo a taquicardia como típica ou atípica) e monitorização da condução retrógrada durante o JET para eventos de risco para BAV. RESULTADOS: Dos 145 pacientes estudados, 132 (91%) preencheram critérios eletrofisiológicos e anatômicos da forma típica da TAVN e 13 (9%), da atípica. Durante a ablação, 5,3% do grupo das típicas e 30,8% das atípicas apresentaram eventos de risco para BAV. Complicações após ablação foram um episódio de BAV total e outro de BAV de primeiro grau nas típicas e um de BAV de primeiro grau nas atípicas. Os três episódios foram precedidos de eventos de risco que resultaram em uma injúria nodal após procedimento. CONCLUSÃO: Portadores de TAVN atípica apresentaram porcentualmente mais eventos preditores de risco para BAV do que os da típica (p = 0,021), sendo fundamental a observação criteriosa da condução retrógrada durante o JET, afim de se evitar permanente da condução nodal, como o BAVT, após o procedimento ablativo.

Wing geometry as a tool for studying the Lutzomyia longipalpis (Diptera: Psychodidae) complex

Toro Toro (T) and Yungas (Y) have been described as genetically well differentiated populations of the Lutzomyia longipalpis (Lutz & Neiva, 1912) complex in Bolivia. Here we use geometric morphometrics to compare samples from these populations and new populations (Bolivia and Nicaragua), representing distant geographical origins, qualitative morphological variation ("one-spot" or "two-spots" phenotypes), ecologically distinct traits (peridomestic and silvatic populations), and possibly different epidemiological roles (transmitting or nor transmitting Leishmania chagasi). The Nicaragua (N) (Somotillo) sample was "one-spot" phenotype and a possible peridomestic vector. The Bolivian sample of the Y was also "one-spot" phenotype and a demonstrated peridomestic vector of visceral leishmaniasis (VL). The three remaining samples were silvatic, "two-spots" phenotypes. Two of them (Uyuni and T) were collected in the highlands of Bolivian where VL never has been reported. The last one (Robore, R) came from the lowlands of Bolivia, where human cases of VL are sporadically reported. The decomposition of metric variation into size and shape by geometric morphometric techniques suggests the existence of two groups (N/Y/R, and U/T). Several arguments indicate that such subdivision of Lu. longipalpis could correspond to different evolutionary units.

Temporal variation of wing geometry in Aedes albopictus

Although native to the tropical and subtropical areas of Southeast Asia, Aedes albopictus is now found on five continents, primarily due to its great capacity to adapt to different environments. This species is considered a secondary vector of dengue virus in several countries. Wing geometric morphometrics is widely used to furnish morphological markers for the characterisation and identification of species of medical importance and for the assessment of population dynamics. In this work, we investigated the metric differentiation of the wings of Ae. albopictus samples collected over a four-year period (2007-2010) in São Paulo, Brazil. Wing size significantly decreased during this period for both sexes and the wing shape also changed over time, with the wing shapes of males showing greater differences after 2008 and those of females differing more after 2009. Given that the wings play sex-specific roles, these findings suggest that the males and females could be affected by differential evolutionary pressures. Consistent with this hypothesis, a sexually dimorphic pattern was detected and quantified: the females were larger than the males (with respect to the mean) and had a distinct wing shape, regardless of allometric effects. In conclusion, wing alterations, particularly those involving shape, are a sensitive indicator of microevolutionary processes in this species.

Latitudinal gradient effect on the wing geometry of Auca coctei (Guérin)(Lepidoptera, Nymphalidae)

Latitudinal gradient effect on the wing geometry of Auca coctei (Guérin) (Lepidoptera, Nymphalidae). When the environmental conditions change locally, the organisms and populations may also change in response to the selection pressure, so that the development of individuals may become affected in different degrees. There have been only a few studies in which the patterns of wing morphology variation have been looked into along a latitudinal gradient by means of geometric morphometrics. The aim of this work was to assess the morphologic differentiation of wing among butterfly populations of the species Auca coctei. For this purpose, 9 sampling locations were used which are representative of the distribution range of the butterfly and cover a wide latitudinal range in Chile. The wing morphology was studied in a total of 202 specimens of A. coctei (150 males and 52 females), based on digitization of 17 morphologic landmarks. The results show variation of wing shape in both sexes; however, for the centroid size there was significant variation only in females. Females show smaller centroid size at higher latitudes, therefore in this study the Bergmann reverse rule is confirmed for females of A. coctei. Our study extends morphologic projections with latitude, suggesting that wing variation is an environmental response from diverse origins and may influence different characteristics of the life history of a butterfly.

In vitro culture of Spondias mombin L. nodal segments

Spondias mombin L. shoot cultures were initiated from nodal explants taken from plants propagated by seeds. Explants coming from 4-6 months old plants, previously disinfected, were cultivated on WPM medium supplemented with a wide range of concentrations of BAP (0.0, 0.22, 0.44, 2.22 and 4.44 muM) and NAA (0.0, 0.27 and 2.70 muM). After four weeks, the responses obtained were axillary shoot and root formation. The first response were preferentially induced with the medium containing only BAP, regardless of the BAP concentration. The addition of NAA on medium reduced significantly axillary shoot formation and induced rhizogenesis. Roots were formed on nodal explant basis, preferentially on medium supplemented with 4.44 muM NAA. The medium supplemented with BAP reduced significantly root formation.

Influence of data acquisition geometry on soybean spectral response simulated by the prosail model

View angle and directional effects significantly affect reflectance and vegetation indices, especially when daily images collected by large field-of-view (FOV) sensors like the Moderate Resolution Imaging Spectroradiometer (MODIS) are used. In this study, the PROSAIL radiative transfer model was chosen to evaluate the impact of the geometry of data acquisition on soybean reflectance and two vegetation indices (Normalized Difference Vegetation Index - NDVI and Enhanced Vegetation Index -EVI) by varying biochemical and biophysical parameters of the crop. Input values for PROSAIL simulation were based on the literature and were adjusted by the comparison between simulated and real satellite soybean spectra acquired by the MODIS/Terra and hyperspectral Hyperion/Earth Observing-One (EO-1). Results showed that the influence of the view angle and view direction on reflectance was stronger with decreasing leaf area index (LAI) and chlorophyll concentration. Because of the greater dependence on the near-infrared reflectance, the EVI was much more sensitive to viewing geometry than NDVI presenting larger values in the backscattering direction. The contrary was observed for NDVI in the forward scattering direction. In relation to the LAI, NDVI was much more isotropic for closed soybean canopies than for incomplete canopies and a contrary behavior was verified for EVI.

Influence of distance, geometry and number of control stations on quality of local geodetic networks for the purpose of georeferencing of rural properties

The implementation of local geodetic networks for georeferencing of rural properties has become a requirement after publication of the Georeferencing Technical Standard by INCRA. According to this standard, the maximum distance of baselines to GNSS L1 receivers is of 20 km. Besides the length of the baseline, the geometry and the number of geodetic control stations are other factors to be considered in the implementation of geodetic networks. Thus, this research aimed to examine the influence of baseline lengths higher than the regulated limit of 20 km, the geometry and the number of control stations on quality of local geodetic networks for georeferencing, and also to demonstrate the importance of using specific tests to evaluate the solution of ambiguities and on the quality of the adjustment. The results indicated that the increasing number of control stations has improved the quality of the network, the geometry has not influenced on the quality and the baseline length has influenced on the quality; however, lengths higher than 20 km has not interrupted the implementation, with GPS L1 receiver, of the local geodetic network for the purpose of georeferencing. Also, the use of different statistical tests, both for the evaluation of the resolution of ambiguities and for the adjustment, have enabled greater clearness in analyzing the results, which allow that unsuitable observations may be eliminated.

Linfoma não-Hodgkin envolvendo tonsila palatina: relato de 3 casos

O objetivo deste trabalho consiste em relatar três casos de linfoma não-Hodgkin (LNH) com acometimento de tonsilas palatinas acompanhados no Hospital Universitário Clementino Fraga Filho (HUCFF) da Universidade Federal do Rio de Janeiro (UFRJ), com pequena revisão de literatura. Os LNH acometem sítios extra-nodais em 25-30% dos casos. Dos casos extra-nodais, 10-30% acometem cabeça e pescoço. Destes casos de LNH em cabeça e pescoço, 60-70% estão presentes no anel de Waldeyer, e deste grupo, algumas séries relatam que 80% encontram-se na tonsila palatina. Concluímos, portanto, que o acometimento das tonsilas pelo LNH constitui uma apresentação incomum desta malignidade hematológica, que merece atenção e destaque para que seja feito diagnóstico precoce, seguido de tratamento e acompanhamento corretos.

Brazil and the economic, political, and environmental multilateralism: the Lula years (2003-2010)

This article discusses Brazil's multilateral policy under Luiz Inácio Lula da Silva's administration, highlighting economic, political and environmental themes. The main argument is that Brazil's multilateral relations during this government reached a new significance with the reinforcement of international coalitions and the articulation with the country's new development model. The country has been using multilateral forums as a way to achieve international projection and support for its development project, highlighting bargaining aspects, variable geometry coalitions and the strengthening of South-South cooperation

Chemical sterilization in in vitro propagation of Arundina bambusifolia Lindl. and Epidendrum ibaguense Kunth

There is a great demand for simpler and less costly laboratory techniques and for more accessible procedures for orchid breeders who do not have the necessary theoretical basis to use the traditional seed and clone production methods of orchids in vitro. The aim of this study was to assess the use of sodium hypochlorite (NaClO) as a decontaminant in the process of inoculating adult orchid explants of Arundina bambusifolia and Epidendrum ibaguenses. Solutions of NaClO (1.200, 2.400, 3.600, 4.800 and 6.000 mg L-1 - equivalent to 50, 100, 150, 200 and 250 mL L-1 of commercial bleach - CB) were sprayed on the explants (1.0 mL) and the culture medium (GB5), in the presence or absence of activated charcoal (2 g L-1). The explants used were nodal segments of field-grown adult plants. The procedures for inoculating the explants were conducted outside the laminar flow chamber (LFC), except for the control treatment (autoclaved medium and explant inoculation inside the LFC). The best results for fresh weight yield, height and number of shoots were obtained using NaClO in solution at 1.200 mg L-1 (equivalent to 50 mL L-1 commercial bleach) with activated charcoal in the culture medium. Fresh weight figures were 1.10 g/jar for Arundina bambusifolia and 0.16 g/jar for Epidendrum ibaguenses. Spraying the NaClO solutions controls the contamination of the culture medium already inoculated with the explants.

Studies on human anti-rabies immunization in Brazil: II - Preliminary evaluation of the 2-1-1 schedule for human pre-exposure anti-rabies immunization, employing suckling mouse brain vaccine

This study reports preliminary results of virus neutralizing antibody (VNA) titers obtained on different days in the course of human anti-rabies immunization with the 2-1-1 schedule (one dose is given in the right arm and one dose in the left arm at day 0, and one dose is apllied on days 7 and 21), recommended by WHO for post-exposure treatment with cell culture vaccines. A variant schedule (double dose on day zero and another on day 14) was also tested, both employing suckling mouse brain vaccine. A complete seroconversion rate was obtained after only 3 vaccine doses, and almost all patients (11 of 12) presented titers higher than 1.0 IU/ml. Both neutralizing response and seroconversion rates were lower in the group receiving only 3 doses, regardless of the sample collecting day. Although our results are lower than those found with cell culture vaccines, the geometry mean of VNA is fully satisfactory, overcoming the lower limit recommended by WHO of 0.5 IU/ml. The 2-1-1 schedule could be an alternative one for pre exposure immunization, shorter than the classical 3+1 regimen (one dose on days 0, 2, 4 and 30) with only three visits to the doctor, instead of four.