1000 resultados para transplant ex mortuo
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Lowering Pulmonary Wedge Pressure after Heart Transplant: Pulmonary Compliance and Resistance Effect
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AbstractBackground:Right ventricular (RV) afterload is an important risk factor for post-heart transplantation (HTx) mortality, and it results from the interaction between pulmonary vascular resistance (PVR) and pulmonary compliance (CPA). Their product, the RC time, is believed to be constant. An exception is observed in pulmonary hypertension because of elevated left ventricular (LV) filling pressures.Objective:Using HTx as a model for chronic lowering of LV filling pressures, our aim was to assess the variations in RV afterload components after transplantation.Methods:We retrospectively studied 159 patients with right heart catheterization before and after HTx. The effect of Htx on hemodynamic variables was assessed.Results:Most of the patients were male (76%), and the mean age was 53 ± 12 years. HTx had a significant effect on the hemodynamics, with normalization of the LV and RV filling pressures and a significant increase in cardiac output and heart rate (HR). The PVR decreased by 56% and CPA increased by 86%. The RC time did not change significantly, instead of increasing secondary to pulmonary wedge pressure (PWP) normalization after HTx as expected. The expected increase in RC time with PWP lowering was offset by the increase in HR (because of autonomic denervation of the heart). This effect was independent from the decrease of PWP.Conclusion:The RC time remained unchanged after HTx, notwithstanding the fact that pulmonary capillary wedge pressure significantly decreased. An increased HR may have an important effect on RC time and RV afterload. Studying these interactions may be of value to the assessment of HTx candidates and explaining early RV failure after HTx.
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AbstractBackground:The recording of arrhythmic events (AE) in renal transplant candidates (RTCs) undergoing dialysis is limited by conventional electrocardiography. However, continuous cardiac rhythm monitoring seems to be more appropriate due to automatic detection of arrhythmia, but this method has not been used.Objective:We aimed to investigate the incidence and predictors of AE in RTCs using an implantable loop recorder (ILR).Methods:A prospective observational study conducted from June 2009 to January 2011 included 100 consecutive ambulatory RTCs who underwent ILR and were followed-up for at least 1 year. Multivariate logistic regression was applied to define predictors of AE.Results:During a mean follow-up of 424 ± 127 days, AE could be detected in 98% of patients, and 92% had more than one type of arrhythmia, with most considered potentially not serious. Sustained atrial tachycardia and atrial fibrillation occurred in 7% and 13% of patients, respectively, and bradyarrhythmia and non-sustained or sustained ventricular tachycardia (VT) occurred in 25% and 57%, respectively. There were 18 deaths, of which 7 were sudden cardiac events: 3 bradyarrhythmias, 1 ventricular fibrillation, 1 myocardial infarction, and 2 undetermined. The presence of a long QTc (odds ratio [OR] = 7.28; 95% confidence interval [CI], 2.01–26.35; p = 0.002), and the duration of the PR interval (OR = 1.05; 95% CI, 1.02–1.08; p < 0.001) were independently associated with bradyarrhythmias. Left ventricular dilatation (LVD) was independently associated with non-sustained VT (OR = 2.83; 95% CI, 1.01–7.96; p = 0.041).Conclusions:In medium-term follow-up of RTCs, ILR helped detect a high incidence of AE, most of which did not have clinical relevance. The PR interval and presence of long QTc were predictive of bradyarrhythmias, whereas LVD was predictive of non-sustained VT.
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Background: Heart transplant rejection originates slow and fragmented conduction. Signal-averaged ECG (SAECG) is a stratification method in the risk of rejection. Objective: To develop a risk score for rejection, using SAECG variables. Methods: We studied 28 transplant patients. First, we divided the sample into two groups based on the occurrence of acute rejection (5 with rejection and 23 without). In a second phase, we divided the sample considering the existence or not of rejection in at least one biopsy performed on the follow-up period (rejection pm1: 18 with rejection and 10 without). Results: On conventional ECG, the presence of fibrosis was the only criterion associated with acute rejection (OR = 19; 95% CI = 1.65-218.47; p = 0.02). Considering the rejection pm1, an association was found with the SAECG variables, mainly with RMS40 (OR = 0.97; 95% CI = 0.87-0.99; p = 0.03) and LAS40 (OR = 1.06; 95% IC = 1.01-1.11; p = 0.03). We formulated a risk score including those variables, and evaluated its discriminative performance in our sample. The presence of fibrosis with increasing of LAS40 and decreasing of RMS40 showed a good ability to distinguish between patients with and without rejection (AUC = 0.82; p < 0.01), assuming a cutoff point of sensitivity = 83.3% and specificity = 60%. Conclusion: The SAECG distinguished between patients with and without rejection. The usefulness of the proposed risk score must be demonstrated in larger follow-up studies.
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v.29:no.1(1954)
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Foi desenvolvido em casa de vegetação, na E. S.A."Luiz de Queiroz", em Piracicaba (SP), um experimento, utilizando-se Latossol Vermelho Amarelo, fase arenosa, originalmente sob vegetação de cerrado, do município de Itirapina (SP), cujo objetivo foi estudar os efeitos de níveis de fósforo (0, 16 e 32 ppm), boro (0, 2 e 4 ppm), zinco (0, 3 e 6 ppm) e calagem (0 e 6,0 g CaCO3 + 2,5 g MgCO3) por vaso no teor de micronutrientes de folhas de Eucalyptus grandis (Hill, Ex-Maiden). O delineamento experimental utilizado foi inteiramente casualizado num esquema fatorial 3³ na presença e ausência de calagem. Cada parcela foi constituída de um vaso contendo 8,0 kg de terra e duas plantas. As adubações com boro e zinco aumentaram as concentrações desses micronutrientes nas folhas das plantas. Verificou-se acúmulo de boro nos tecidos das folhas, em níveis considerados tóxicos, quan do se adicionou ao solo 2 e 4 ppm de boro. A calagem diminuiu as concentrações de zinco das folhas das plantas.
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Foi desenvolvido um experimento em casa de vegetação na Escola Superior de Agricultura "Luiz de Queiroz", em Piracicaba (SP) utilizando-se Latossol Vermelho Amarelo, fase arenosa, originalmente sob vegetação de cerrado, do município de Itirapina (SP), com o objetivo de estudar o efeito de três níveis de P (0, 16 e 32 ppm), três níveis de B (0, 2 e 4 ppm), tres níveis de Zn (0, 3 e 6 ppm) e dois níveis de calagem (0 e 6,0 g CaCO3 + 2,5 g MgC0(3)) por cada vaso no crescimento em altura e na produção de matéria seca de mudas de Eucalyptus grandis (Hill, Ex-Maiden). A adubação fosfatada, provocou aumento no crescimento em altura e na produção de matéria seca das plantas. A adição de 2 e 4 ppm de boro ao solo, provocou efeitos de interação com calagem, fósforo e zinco, ocasionando alterações no crescimento em altura das plantas. A adição de 3 e 6 ppm de zinco ao solo, ocasionou interação com o boro e fósforo adicionados, diminuindo o crescimento em altura das plantas.
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Utilizando-se um Latossol Vermelho Amarelo fase arenosa, originalmente sob vegetação de Cerrado do município de Itirapina (SP), foi desenvolvido um experimento em vasos, em casa de vegetação, na E. S.A. "Luiz de Queiroz", em Piracicaba (SP), com a finalidade de se verificar o efeito da aplicação de níveis de P (0, 16 e 32 ppm), níveis de B (0, 2 e 4 ppm), níveis de Zn (0, 3 e 6 ppm) e níveis de calagem (0 e 6,0 g CaCO3 + 2,5 g MgCO3) por cada vaso, na concentração de N, P, K, Ca e Mg das folhas de mudas de Eucalyptus grandis (Hill, Ex-Maiden), A calagem e as adubações fosfatadas, com boro ou com zinco, alteraram as concentrações dos macronutrientes dos tecidos foliares das plantas.
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Este trabalho trata do estudo da biologia de Rolepa unimoda (Dognin,1923) (Lepidoptera, Lymantriidae), cujas lagartas são desfolhadoras em plantios ornamentais de Tabebuia avellanedae Lor. ex-Griseb (Bignoniaceae). Ataca também T. caraiba (Mart.) Burm. Os insetos foram criados em condições de laboratório (Temperatura 27±2°C; UR: 70 ± 15%, Fotoperíodo de 12 h), na Seção de Entomologia do Centro de Ciências Agrárias da Fundação Universidade Federal de Mato Grosso, em Cuiabá, MT. Foram estudados os seguintes parâmetros: período e viabilidade das fases de ovos,lagarta, pré-pupa e pupa; número e duração dos ínstares larvais e consumo foliar da fase de lagarta; longevidade dos adultos e proporção quanto ao sexo; inimigos naturais; plantas hospedeiras e ocorrência do inseto nos Estados de Mato Grosso e Mato Grosso do Sul.
