Qual o erro da angiografia na definição de isquemia miocárdica durante intervenções coronarianas percutâneas?

FUNDAMENTO: A angiografia vem sendo utilizada como padrão de referência para definição de doença arterial coronariana (DAC), embora suas limitações sejam conhecidas. O valor da medida do fluxo fracionado de reserva do miocárdio (FFR) na avaliação da DAC está bem estabelecido. OBJETIVO: O objetivo deste estudo é avaliar a acurácia da angiografia em definir as lesões isquêmicas e sua correlação com o FFR. MÉTODOS: Duzentos e cinqüenta pacientes foram incluídos no estudo (471 vasos). Todas as estenoses > 50% pela estimativa visual da angiografia (EVA) foram avaliadas medindo-se o FFR. Se o FFR <0,75 a lesão foi tratada, se o FFR >0,75 a lesão não foi tratada. As lesões foram divididas em moderadas (<70% - 327) e graves (125) pela QCA. Foram determinados o coeficiente de correlação entre o grau de estenose (%DE), o FFR e a acurácia da EVA em definir se uma lesão era ou não isquêmica. RESULTADOS: Foi possível obter o FFR em 96% das lesões. %DE e FFR médios de 56±8% e 0,74 e 76±6% e 0,48 para as lesões moderadas e graves respectivamente. Notou-se pobre correlação entre o %DE e o FFR, especialmente nas lesões moderadas (Spearman rho = - 0.33, p<0,0001). A acurácia da EVA comparada com FFR foi de 57% e 96% nas lesões moderadas versus graves. CONCLUSÃO: A angiografia coronária não é adequada para avaliar a importância funcional das lesões coronarianas, sendo necessário associá-la a um método funcional capaz de fazê-lo, especialmente nas lesões moderadas.

Hemodynamic Effect of Laser Therapy in Spontaneously Hypertensive Rats

Systemic arterial hypertension (SAH) is considered to be the greatest risk factor for the development of neuro-cardiovascular pathologies, thus constituting a severe Public Health issue in the world. The Low-Level Laser Therapy (LLLT), or laser therapy, activates components of the cellular structure, therefore converting luminous energy into photochemical energy and leading to biophysical and biochemical reactions in the mitochondrial respiratory chain. The LLLT promotes cellular and tissue photobiomodulation by means of changes in metabolism, leading to molecular, cellular and systemic changes. The objective of this study was to analyze the action of low-level laser in the hemodynamic modulation of spontaneously hypertensive rats, in the long term. Animals (n = 16) were randomly divided into the Laser Group (n = 8), which received three weekly LLLT irradiations for seven weeks, and into the Sham Group (n = 8), which received three weekly simulations of laser for seven weeks, accounting for 21 applications in each group. After seven weeks, animals were cannulated by the implantation of a catheter in the left carotid artery. On the following day, the systemic arterial pressure was recorded. The Laser Group showed reduced levels of mean blood pressure, with statistically significant reduction (169 ± 4 mmHg* vs. 182 ± 4 mmHg from the Sham Group) and reduced levels of diastolic pressure (143 ± 4 mmHg* vs. 157 ± 3 mmHg from the Sham Group), revealing a 13 and 14 mmHg decrease, respectively. Besides, there was a concomitant important decline in heart rate (312 ± 14 bpm vs. 361 ± 13 bpm from the Sham Group). Therefore, laser therapy was able to produce hemodynamic changes, thus reducing pressure levels in spontaneously hypertensive rats.

Reações fisiológicas de resistência à Xanthomonas malvacearum (E. P. Smith) Dowson, em algumas variedades de algodão

No presente trabalho foi observado o comportamento das variedades Stoneville-20, Nu-16, Gregg, Mebane, RM2 e IAC-12, quando üioculadas com um isolamento de Xanthomanas malvacearum (E. F. Smiith) Dowson, em condições de casa de vegetação e das variedades Stoneville-20, Nu-16, RM4 e RM2, quando em condições de campo. Pelos dados dados, obtidos, as variedades Stoneville-20 e Nu-16 mostraram-se resistentes ao isolamento testado, enquanto que as variedades RM4, Gregg, Mebane e IAC-12 máostraram-se suscetíveis. A variedade RM2 testada continha plantas que apresentavam reações fisiológicas, de resistência e suscetibilidade. Dentre as, progênies obtidas de plantas da variedade RM2 selecionadas em campo como resistentes só aproximadamente 20% mostraram alto grau de resistência quando testadas em casa de vegetação.

Variação da composição de aminoácidos em caules e raízes de algodoeiro (Gossypium hirsutum L.) de acôrdo com a suscetibilidade aFusarium oxysporwn f. vasinfectum (Atk.) SNYD e HANS

Os resultados do estudo da variação na composição dos aminoácidos em caules e raízes de plantas de algodoeiro resistentes e suscetíveis a Fusarium oxysporum f. vasinfectum, revelaram maiores diferenças nos caules, quando comparados com aquêles obtidos para raízes. No estágio cotiledonar, tanto para plantas inoculadas como n]ao inoculadas, os caules de plantas da variedade suscetível apresentaram maior teor de aminoácidos, quando comparados com aquêles de plantas resistentes. Os caules das plantas suscetíveis em estágio de 3a 4 fôlhas verdadeiras, quando inoculadas, apresentaram maior teor de aminoácidos, quando comparadas com aquêles de plantas resistentes inoculadas com a mesma idade. Porém, para o caso de plantas não inoculadas, o teor de aminoácidos das plantas suscetíveis era ligeiramente inferior que o observado para as plantas resistentes.

The pineal neurohormone melatonin and its physiologic opiatergic immunoregulatory role

The pineal gland functions as a neuroendocrine transducer that coordinate the organism response to changing environmental stimuli such as light and temperature. The main and best known pineal neurohormone is melatonin that is synthesized and released in a circadian fashion with a peak during the night darkness hours. We have recently reported that melatonin exerts important immuno regulatory functions. Here we describe the astonishing property of exogenous melatonin which is able to counteract completely the depressive effect of anxiety-restraint stress and/or of corticosterone on thymus weight, andibody production and antiviral responses. This effect seems to be mediated by antigen-activated T cells via an opiatergic mechanism.

A new host of Trypanosoma cruzi from Jujuy, Argentina: octodontomys gliroides (Gervais & D'Orbigny, 1844) (Rodentia, Octodontidae)

To identify wild hosts of Trypanosoma cruzi, surveys were conducted in the subandean valleys of Jujuy Province, Argentina, between June 1986 and March 1987. Seventy two mammals from 13 different species were examined by xenodiagnosis. Fifty two of them were mostly roedents trapped at the localities of Maimará, León and Tilcara, and the remainder had been kept in captivity at the Estación Biológica Experimental, in Jujuy. Trypanosoma cruzi infection was detected only in 2 Octodontomys gliroides (2 pos./8 exam. 25%) from all 72 examined mammals. Isolates were called Octodontomys Argentina 1 and 2 (OA1 and OA2). Both infected animals were caught at the archaelogical ruin of Pucará, at Tilcara. Repeated searches for triatomines in the ruin itself and in neighbour houses rendered negative results. Groups of mice inoculated with either OA1 or OA2 isolates became infected between 7 (OA1) to 12 days (OA2) postinoculation PI. Parasitemia peaks were observed between day 12th - 14th PI. Scarce amastigote nests were found in myocardium and skeletal muscle. Mortality was observed only for mice inoculated with OA1. Isoenzyme patterns of OA1 and OA2 were identical to one found in dogs and slightly different from that of human parasites in Argentina. Bones from Octodontomys sp., were recently found in a cave, dated 10200-8600 BC, in Pumamarca, near Tilcara, Jujuy. There are evidences that O. gliroides cohabited with man in ancient times and was associated to the domestic cycle of T. cruzi transmission, playing a role like that of domestic cavies. in Bolivia.

Nutrition and acute schistosomiasis

In northeast Brazil, nutritional deficiency diseases and schistosomiasis mansoni overlap. An experimental model, wich reproduces the marasmatic clinical form of protein-energy malnutrition, was developed in this laboratory to study these interactions. Albino Swiss mice were fed with a food association ingested usually by human populations in northeast Brazil. This diet (Regional Basic Diet - RBD) has negative effects on the growth, food intake and protein utilization in infected mice (acute phase of murine schistosomiasis). Nitrogen balance studies have also shown that infection with Schistosoma mansoni has apparently no effect on protein intestinal absorption in well nourished mice. However, the lowest absorption ratios have been detected among RBD - fed infected animals, suggesting that suprerimposed schistosome infection aggravated the nutritional status of the undernourished host. The serum proteins electrophoretic pattern, as far as albumins are concerned, is quite similar for non-infected undernourished and infected well-fed animals. So, the significance of albumins as a biochemical indicator of the nutritional status of human populations residing in endemic foci of Manson's schistosomiasis, is discussable.

Intestinal protein absorption in malnourished mice with acute schistosomiasis mansoni

Intestinal protein absorption was studied in undernourished albino Swiss mice with acute schistosomiasis mansoni. Undernutrition was induced by feeding mice with the Regional Basic Diet (RBD) ingested by human populations in Northeast Brazil, an experimental model previously developed in our laboratory. Weaning mice were infected with 40 cercariae and compared to undernourished non-infected mice and/or to infected mice fed a balanced control diet. Apparent and True Protein Absorption Coefficients were determined by nitrogen balance during five consecutive days ending at the 63rd day of the trial (acute phase of murine schistosomiasis). Fecal metabolic nitrogen (FMN) was determined after administration of a non-protein diet and was also calculated through linear regression. Our results showed a reduced protein absorption in non-infected RBD-fed mice as compared to mice fed a casein control diet. Infection with Schistosoma mansoni had apparently no effect on intestinal protein absorption in well-nourished mice. However, infection seemed to interfere with protein absorption in under-nourished animals, since the lowest absorption ratios have been detected among RBD-fed infected mice. A brief discussion is made on the advantages of using the method of linear regression for the determination of FMN.

The interaction between Poultry and Triatoma infestans Klug, 1834 (Hemiptera: Reduviidae) in an experimental model

This paper compares the predation pressure that ducks and chickens exert on triatomines. For the tests, these birds were placed in individual boxes together with a known number of Triatoma infestans and left to interact from 6 p.m. till the next morning, involving a long lasting period of complete darkness limited by two short-term periods of semi-darkness. There was a shelter which could prevent the bugs from being predated. The number of live and dead triatomines was recorded, considering missing bugs as predated by the birds. Ducks exhibited a greater predatory activity than chickens, that could be due to a long term active period at night while chickens sleep motionless from sunset to dawn. Surviving triatomines that had fed on chickens outnumbered those fed on ducks suggesting that these were less accessible to the triatomine biting. If ducks are better than chickens to detect and eat bugs and to interfere with their feeding in the field, an increase in duck number might help to diminish triatomine density. Further research is needed to determine the feasibility of application of these experimental results.

Interaction between Didelphis albiventris and Triatoma infestans in relation to Trypanosoma cruzi transmission

This paper attempts to prove if a high Trypanosoma cruzi prevalence of opossums might be reached with few potential infective contacts. One non-infected Didelphis albiventris to T. cruzi and 10 infected nymphs of Triatoma infestans were left together during 23 hr in a device that simulated a natural opossum burrow. Twenty-six replicates were perfomed using marsupials and triatomines only once. Potentially infective contacts occurred in all the trials. From the 26 opossums used in trials, 54% did not eat any bug. Of the 260 bugs used, 21% were predated. In the 25 trials involving 205 surving bugs, 36 % of them did not feed. In 15/25 cases, maior ou igual a 60% of the triatomines were able to feed. The parasitological follow-up of 24 opossums showed that among 10 that had eaten bugs, 4 turned out infected and among the 14 that had not predate, 3 (21%) became positive. In sum, 7/24 (29%) of the marsupials acquired the infection after the experiment. This infection rate was similar to the prevalences found for the opossum population of Santiago del Estero, Argentina, suggesting that the prevalences observed in the field might be reached if each marsupial would encounter infected bugs just once in its lifetime.

A long-term intake of a protein hydrolysate seems to increase the risk of encephalopathy in mice infected with Schistosoma mansoni

Previous investigations showed that Schistosoma mansoni infection aggravates protein malabsorption in undernourished mice and this can be reverted by administration of casein hydrolysate. The present study was undertaken to evaluate the effects of ingestion of casein hydrolysate for long periods. Albino Swiss mice were divided into eight groups. Diets contained 5% (undernourished ) or 20% (controls) casein levels. For each group there were sub-groups ingesting whole or hydrolysed casein for 12 weeks. Infection with S. mansoni developed in half of the animals under each diet. All undernourished mice developed malabsorption. Low albuminemia was detected in infected animals independently of the protein level in the diet. However, albuminemia was lower in infected controls than in undernourished non-infected mice, suggesting a deficient liver protein synthesis. Infected mice fed on a 20% protein hydrolysed diet exhibited low weight gain and high mortality rates. On the other hand, non-infected mice ingesting the same diet had the highest body weights. We are investigating the hypothesis that infected mice, even when fed normal diets, are unable to metabolise large amounts of amino acids due to the liver lesions related to schistosomiasis and as a result die of hepatic coma. In some of them, the excessive accumulation of ammonia in the blood enhances the outcome of an encephalopathy.

"In vivo" imaging of atherosclerosis

Atherosclerosis is a systemic and multifocal disease, which starts early in life, and that usually takes decades before overt disease eventually appears as a consequence of progressive obstruction or abrupt thrombotic occlusion. This silent course makes necessary to develop predictors of disease long before symptomatic lesions develop. Besides several classical risk factors and new emerging humoral risk predictors, imaging may constitute a formidable diagnostic and prognostic tool in order to identify presence, extension, progression (or regression) of disease as well as vulnerability of atherosclerotic lesions. This review summarizes the rapidly growing clinical and research field in imaging atherosclerosis from different perspectives opening important opportunities for timely detection and treatment of atherosclerosis.

Effect of Lutzomyia whitmani (Diptera: Psychodidae) salivary gland lysates on Leishmania (Viannia) braziliensis infection in BALB/c mice

Previous reports showed that Lutzomyia longipalpis saliva exacerbate Leishmania braziliensis infection in mice. The sand fly Lu. whitmani is one of the vectors of L. (Viannia) braziliensis (LVb), a causative agent of cutaneous leishmaniasis in the State of Ceará, Brazil. To determine whether saliva of Lu. whitmani could increase the infectivity of LVb in mice, we inoculated groups of BALB/c mice with LVb promastigotes in the presence or absence of the salivary glands lysate from Lu. whitmani. We found that coinjection with Lu. whitmani saliva increased size but not longevity of cutaneous LVb lesions in BALB/c mice, since the formed lesions gradually resolved. The mechanism(s) by which Lu. whitmani saliva might exacerbate LVb infection in BALB/c mice is speculated.