951 resultados para PH VALVE


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Acid-sensing ion channels (ASICs) are key receptors for extracellular protons. These neuronal nonvoltage-gated Na(+) channels are involved in learning, the expression of fear, neurodegeneration after ischemia, and pain sensation. We have applied a systematic approach to identify potential pH sensors in ASIC1a and to elucidate the mechanisms by which pH variations govern ASIC gating. We first calculated the pK(a) value of all extracellular His, Glu, and Asp residues using a Poisson-Boltzmann continuum approach, based on the ASIC three-dimensional structure, to identify candidate pH-sensing residues. The role of these residues was then assessed by site-directed mutagenesis and chemical modification, combined with functional analysis. The localization of putative pH-sensing residues suggests that pH changes control ASIC gating by protonation/deprotonation of many residues per subunit in different channel domains. Analysis of the function of residues in the palm domain close to the central vertical axis of the channel allowed for prediction of conformational changes of this region during gating. Our study provides a basis for the intrinsic ASIC pH dependence and describes an approach that can also be applied to the investigation of the mechanisms of the pH dependence of other proteins.

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O objetivo deste trabalho foi definir um modelo matemático que estime o H+Al a partir do pH SMP medido em água e em solução de CaCl2 0,01 mol L-1 nas condições edafoclimáticas locais. Foram utilizadas 246 amostras de solo provenientes de diversas localidades. Mesmo apresentando menor coeficiente da correlação (r = 0,89*), a equação H+Al = 30,646 - 3,848pH SMP obtida em H2O foi mais eficiente que a obtida em solução CaCl2 (H+Al = 30,155 - 3,834pH SMP, r = 0,91*), a qual subestima os valores da acidez potencial.

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The remaining phosphorus (Prem) has been used for estimating the phosphorus buffer capacity (PBC) of soils of some Brazilian regions. Furthermore, the remaining phosphorus can also be used for estimating P, S and Zn soil critical levels determined with PBC-sensible extractants and for defining P and S levels to be used not only in P and S adsorption studies but also for the establishment of P and S response curves. The objective of this work was to evaluate the effects of soil clay content and clay mineralogy on Prem and its relationship with pH values measured in saturated NaF solution (pH NaF). Ammonium-oxalate-extractable aluminum exerts the major impacts on both Prem and pH NaF, which, in turn, are less dependent on soil clay content. Although Prem and pH NaF have consistent correlation, the former has a soil-PBC discriminatory capacity much greater than pH NaF.

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Les manifestations ORL du reflux gastro-œsophagien sont fréquentes. La pH-impédancemétrie permet d’évaluer des reflux acides ou non acides et de déterminer leur extension proximale. A la lumière de deux patients de notre collectif, nous observons une corrélation entre reflux non acide et symptômes ORL dans le premier cas et une suppression acide insuffisante dans le deuxième cas. Ces résultats nous orientent vers un traitement spécifique complémentaire aux inhibiteurs de la pompe à protons. La pH-impédancemétrie détecte les reflux aussi bien acides que non acides, et analyse la concordance entre les symptômes et les épisodes de reflux. Elle permet ainsi une meilleure compréhension des manifestations ORL du reflux gastro-œsophagien et une prise en charge thérapeutique mieux adaptée. ENT symptoms of gastro-esophageal reflux are frequent. pH-impedance can detect acid and non-acid reflux and measure their proximal extension. The technique identifies the refluxate by changes in impedance. We discuss 2 clinical situations where correlation of symptoms could be explained by a non-acid reflux in the first case, and a lack of acid suppression in the second case, respectively. These results lead to a specific additional treatment to proton pump inhibitors (PPI). This technology provides a better understanding of the pathogenesis of reflux laryngitis, and affords the prescription of PPI on a proven diagnosis. Detection of non-acid reflux leads to an optimized medical treatment.

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AIMS: To evaluate short-term clinical outcomes following transcatheter aortic valve implantation (TAVI) using CE-mark approved devices in Switzerland. METHODS AND RESULTS: The Swiss TAVI registry is a national, prospective, multicentre, monitored cohort study evaluating clinical outcomes in consecutive patients undergoing TAVI at cardiovascular centres in Switzerland. From February 2011 to March 2013, a total of 697 patients underwent TAVI for native aortic valve stenosis (98.1%), degenerative aortic bioprosthesis (1.6%) or severe aortic regurgitation (0.3%). Patients were elderly (82.4±6 years), 52% were females, and the majority highly symptomatic (73.1% NYHA III/IV). Patients with severe aortic stenosis (mean gradient 44.8±17 mmHg, aortic valve area 0.7±0.3 cm²) were either deemed inoperable or at high risk for conventional surgery (STS 8.2%±7). The transfemoral access was the most frequently used (79.1%), followed by transapical (18.1%), direct aortic (1.7%) and subclavian access (1.1%). At 30 days, rates of all-cause mortality, cerebrovascular events and myocardial infarction were 4.8%, 3.3% and 0.4%, respectively. The most frequently observed adverse events were access-related complications (11.8%), permanent pacemaker implantation (20.5%) and bleeding complications (16.6%). The Swiss TAVI registry is registered at ClinicalTrials.gov (NCT01368250). CONCLUSIONS: The Swiss TAVI registry is a national cohort study evaluating consecutive TAVI procedures in Switzerland. This first outcome report provides favourable short-term clinical outcomes in unselected TAVI patients.

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Atrial septal defects (ASDs) are typically asymptomatic in infancy and early childhood, and elective defect closure is usually performed at ages of 4 to 6 years. Severe pulmonary hypertension (PH) complicating an ASD is seen in adulthood and has only occasionally been reported in small children. A retrospective study was undertaken to evaluate the incidence of severe PH complicating an isolated ASD and requiring early surgical correction. During a 10-year period (1996 to 2006), 355 pediatric patients underwent treatment for isolated ASDs either surgically or by catheter intervention at 2 tertiary referral centers. Two hundred ninety-seven patients had secundum ASDs, and 58 had primum ASDs with mild to moderate mitral regurgitation. Eight infants were found with isolated ASDs (6 with secundum ASDs and 2 with primum ASDs) associated with significant PH, accounting for 2.2% of all patients with ASDs at the centers. These 8 infants had invasively measured pulmonary artery pressures of 50% to 100% of systemic pressure. They were operated in the first year of life and had complicated postoperative courses requiring specific treatment for PH for up to 16 weeks postoperatively. The ultimate outcomes in all 8 infants were good, with persistent normalization of pulmonary pressures during midterm follow-up of up to 60 months (median 28). All other patients with ASDs had normal pulmonary pressures, and the mean age at defect closure was significantly older, at 6.2 years for secundum ASDs and 3.2 years for primum ASDs. In conclusion, ASDs were rarely associated with significant PH in infancy but then required early surgery and were associated with excellent midterm outcomes in these patients.

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O objetivo deste trabalho foi avaliar o efeito do alumínio sobre a capacidade das cultivares de arroz Fernandes (tolerante) e Maravilha (sensível) de modificar o pH de soluções nutritivas com diferentes proporções de NO3-/NH4+ . Após exposição das plantas ao Al (0 mM e 1,5 mM), durante 15 dias, foram determinados: quantidade de prótons exsudados, alongamento, produção de matéria seca e teor de Al nas raízes e folhas. O alongamento e produção de matéria seca, de raízes e folhas, se reduziram em presença de Al, independentemente da proporção NO3-/NH4+ , e essas reduções se intensificaram com o aumento na concentração de NH4+. Os teores de Al aumentaram nas raízes e folhas, com aumento na concentração de NH4+ na solução nutritiva. Houve forte alcalinização da solução nutritiva com nitrogênio exclusivamente na forma de NO3-, que se reduziu em presença de Al. Em soluções nutritivas com NH4+, ao contrário, observou-se acidificação, que se intensificou com aumento na concentração de NH4+. A cultivar tolerante sempre consumiu mais prótons da solução nutritiva com N exclusivamente na forma de NO3-, e menos prótons daquela que continha NH4+, independentemente da proporção NO3-/NH4+ . Essa cultivar foi, portanto, capaz de ajustar seu balanço de prótons e modificou o pH para valores que favoreciam menor absorção e maior tolerância ao alumínio.

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BACKGROUND: Aortoplasty has been advocated for moderate dilatation of the ascending aorta associated with aortic valve disease. We report our results with this conservative approach. METHODS: Seventeen consecutive patients with unsupported aortoplasty were reviewed. Twelve patients had aortic valve regurgitation and 5 had stenosis. The aortic wall was analyzed histologically in 14 patients. Follow-up was complete, with a mean time of 6 years (range, 2.3 to 10.5 years). RESULTS: Two patients among the 15 hospital survivors died during follow-up of causes unrelated to aortic pathology. Survival at 7 years was 86.7% (+/- 8.8%). Recurring aortic aneurysms developed in 4 patients after a mean time of 63 months, with an event-free survival at 7 years of 41% (+/- 21%). All of these 4 patients had aortic valve regurgitation and cystic medial necrosis. CONCLUSIONS: The recurrence rate of aneurysms after unsupported aortoplasty and aortic valve replacement is high in patients with aortic regurgitation. This strongly suggests that in these patients, the aortic dilatation is related to an underlying wall deficiency, associated with the aortic valve pathology, rather than to the hemodynamic stress imposed by the aortic valve disease.

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PURPOSE OF REVIEW: The safety and efficiency of trans catheter aortic valve implantation (TAVI) has been clearly demonstrated. In high-risk patients, the number of procedures is constantly increasing and in western European countries this procedure is employed in more than 30% of isolated aortic valve replacements. The literature, however, focusing on perioperative aortic root (AoR) rupture is rather limited to just a few reports. The aim of this review is to analyze the pathophysiology of AoR rupture during TAVI, stressing the implications of the morphology of the AoR for this devastating complication. RECENT FINDINGS: Currently, perioperative AoR rupture ranges between 0.5 and 1.5% during TAVI, with almost 100% mortality. Recently, valve oversizing and balloon dilatation in a calcified and small AoR were considered as the most important predictive factors for this complication. SUMMARY: The most fragile unit of the AoR is its anchoring substrate to the ostium of the left ventricle. This membranous structure is not involved in the degenerative process leading to aortic valve stenosis. Due to the TAVI and/or balloon dilatation of the calcium stationed on the three leaflets and their attachment, a lesion may result on this structure. And, as a consequence, there is rupture of the AoR.

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In some high-risk patients, standard mitral valve replacement can represent a challenging procedure, requiring a risky extensive decalcification of the annulus. In particular, high-risk redo patients and patients with a previously implanted transcatheter aortic valve, who develop calcific mitral disease, would benefit from the development of new, minimally invasive, transcatheter or hybrid techniques for mitral valve replacement. In particular, mixing transcatheter valve therapies and well-established minimally invasive techniques for mitral replacement or repair can help in decreasing the surgical risk and the technical complexity. Thus, placing transcatheter, balloon-expandable Sapien? XT stent-valves in calcified, degenerated mitral valves through a right thoracotomy, a left atriotomy and on an on-pump fibrillating heart, represents an attractive alternative to standard surgery in redo patients, in patients with concomitant transcatheter aortic stent-valves in place and in patients with a high-risk profile. We describe this hybrid technique in detail.

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O trabalho teve como objetivo avaliar a distribuição de formas de cobre, em função do pH e da adição de cama-de-frango, em amostras da camada superficial (0 a 10 cm) de um Neossolo Litólico distrófico típico e de um Cambissolo Húmico alumínico típico, da região da Serra Gaúcha, cultivados por mais de 15 anos com parreirais que receberam aplicações sucessivas de produtos fitossanitários à base de cobre. Para avaliar os efeitos da variação do pH e do teor de matéria orgânica do solo nas formas de cobre, cinco doses de HNO3 (50, 100, 200, 300 e 400 mmol kg-1) e quatro doses de cama-de-frango em base seca (10, 20, 40 e 80 t ha-1) foram adicionadas aos solos. As frações observadas foram: trocável; ligada à matéria orgânica; ligada a óxidos de Fe, de Al e de Mn; e fração residual. A maior proporção do cobre dos solos esteve ligada à fração orgânica (entre 70 e 80%). Com a diminuição do pH (de 6,8 para 3,8), os teores de cobre trocável aumentaram, enquanto os teores de cobre ligados às frações matéria orgânica, óxidos e residual diminuíram. A adição de cama-de-frango não afetou significativamente a distribuição das formas de cobre nos solos, com exceção dos teores trocáveis.

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Urinary magnesium and pH are known to modulate urinary calcium excretion, but the mechanisms underlying these relationships are unknown. In this study, the data from 17 clinical trials in which urinary magnesium and pH were pharmacologically manipulated were analyzed, and it was found that the change in urinary calcium excretion is directly proportional to the change in magnesium excretion and inversely proportional to the change in urine pH; a regression equation was generated to relate these variables (R(2) = 0.58). For further exploration of these relationships, intravenous calcium chloride, magnesium chloride, or vehicle was administered to rats. Magnesium infusion significantly increased urinary calcium excretion (normalized to urinary creatinine), but calcium infusion did not affect magnesium excretion. Parathyroidectomy did not prevent this magnesium-induced hypercalciuria. The effect of magnesium loading on calciuria was still observed after treatment with furosemide, which disrupts calcium and magnesium absorption in the thick ascending limb, suggesting that the effect may be mediated by the distal nephron. The calcium channel TRPV5, normally present in the distal tubule, was expressed in Xenopus oocytes. Calcium uptake by TRPV5 was directly inhibited by magnesium and low pH. In summary, these data are compatible with the hypothesis that urinary magnesium directly inhibits renal calcium absorption, which can be negated by high luminal pH, and that this regulation likely takes place in the distal tubule.

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O objetivo deste trabalho foi avaliar a dinâmica do pH da água das chuvas em Passo Fundo, RS, de 1992 a 2007. A água foi coletada em recipiente de PVC (diâmetro de 10 cm) acoplado a um pluviômetro, e as amostras foram armazenadas em congelador para posterior determinação do pH. A dinâmica do pH da água foi avaliada por meio das médias mensais e anuais do pH, da probabilidade empírica da distribuição dos valores anuais de pH por estação do ano e da frequência relativa acumulada do pH. A água das chuvas incidentes na região de Passo Fundo apresentou pH acima de 5,6, que é o limite para que a chuva seja considerada ácida. A análise do período de 16 anos indicou tendência de redução do pH da água das chuvas em 0,023 ao ano. Nesse período, a redução foi de 6,1 para 5,8. As chuvas foram ligeiramente mais ácidas no verão e na primavera do que no outono e no inverno. Em geral, as chuvas incidentes na região não apresentaram riscos imediatos de acidificação ambiental.

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Este trabalho foi desenvolvido com o objetivo de avaliar a eficácia e o pH de caldas de glifosato após a adição de fertilizantes nitrogenados e utilização de pulverizador pressurizado por CO2. Em campo, foram aplicadas duas doses de glifosato (360 e 720 g ha-1), isoladas ou combinadas a duas concentrações de ureia (2,5 e 5,0 g L-1) ou sulfato de amônio (7,5 e 15,0 g L-1). Em laboratório, mensurou-se o pH de caldas de glifosato após o uso de diferentes concentrações do produto e dos fertilizantes nitrogenados e após a utilização do pulverizador pressurizado por CO2. Em todas as avaliações do experimento em campo, a menor dose de glifosato teve maior eficácia biológica após a adição de sulfato de amônio (15 g L-1) à calda. A ureia (5 g L-1) proporcionou efeitos benéficos somente na avaliação aos 28 dias após a aplicação. Em laboratório, o aumento da concentração de glifosato promoveu gradativa acidificação da calda de pulverização, com estabilização do pH da solução em 4,5. O sulfato de amônio causou pequena acidificação da calda herbicida, enquanto a ureia não alterou o pH. O uso do pulverizador pressurizado por CO2 pouco alterou o pH da calda de glifosato. A maior eficácia do glifosato após a adição de fertilizantes nitrogenados à calda está pouco relacionada com alterações no pH da solução.

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Aspergillus fumigatus grows well at neutral and acidic pH in a medium containing protein as the sole nitrogen source by secreting two different sets of proteases. Neutral pH favors the secretion of neutral and alkaline endoproteases, leucine aminopeptidases (Laps) which are nonspecific monoaminopeptidases, and an X-prolyl dipeptidase (DppIV). Acidic pH environment promotes the secretion of an aspartic endoprotease of pepsin family (Pep1) and tripeptidyl-peptidases of the sedolisin family (SedB and SedD). A novel prolyl peptidase, AfuS28, was found to be secreted in both alkaline and acidic conditions. In previous studies, Laps were shown to degrade peptides from their N-terminus until an X-Pro sequence acts as a stop signal. X-Pro sequences can be then removed by DppIV, which allows Laps access to the following residues. We have shown that at acidic pH Seds degrade large peptides from their N-terminus into tripeptides until Pro in P1 or P'1 position acts as a stop for these exopeptidases. However, X-X-Pro and X-X-X-Pro sequences can be removed by AfuS28 thus allowing Seds further sequential proteolysis. In conclusion, both alkaline and acidic sets of proteases contain exoprotease activity capable of cleaving after proline residues that cannot be removed during sequential digestion by nonspecific exopeptidases.