Influence of fresh frozen plasma as a trigger factor for kidney dysfunction in cardiovascular surgery

OBJETIVO: A disfun����o renal �� uma complica����o importante no cen��rio de p��s-operat��rio de cirurgia cardiovascular. Como fatores de risco conhecidos no intraoperat��rio para o seu desenvolvimento destacam-se a circulação extracorp��rea, a hemodilui����o, drogas antifibrinol��ticos e a transfus��o sangu��nea. O objetivo deste estudo �� identificar os fatores de risco na transfus��o de sangue e derivados para o desenvolvimento de disfun����o renal em pacientes submetidos �� cirurgia cardiovascular. M��TODOS: Noventa e sete pacientes foram estudados e 84 foram analisados. A amostra foi estratificada em dois grupos, sendo que o incremento de 30% na creatinina s��rica no p��s-operat��rio foi considerado para o grupo com disfun����o renal (n = 9; 10,71%). O grupo n��o disfun����o renal foi caracterizado pela creatinina s��rica, que permaneceu inferior a aumento de 30% no p��s-operat��rio (n = 75; 89,28%). RESULTADOS: Foi observado que a transfus��o de plasma fresco congelado no grupo n��o disfun����o renal foi de 2,05 �� 0,78 unidades e 3,80 �� 2,16 unidades no grupo disfun����o renal com P= 0,032. CONCLUS��O: Foi poss��vel associar, nesta s��rie de pacientes, que a transfus��o de plasma fresco congelado foi um fator de risco para disfun����o renal p��s-operat��rio de cirurgia cardiovascular.

Irriga����o do test��culo em eq��ino da ra��a Puro-Sangue Ingl��s

Estudamos o comportamento da art��ria testicular e seus ramos, bem como o n��mero e distribui����o dos vasos penetrantes, em 30 pares de test��culos de eq��inos da ra��a Puro-Sangue Ingl��s, adultos, mediante an��lise de esquemas de modelos obtidos pela corros��o ap��s inje����o de acetato de vinil. Verificamos que a art��ria testicular apresenta 5 diferentes tipos de arranjos vasculares, isto ��: a art��ria testicular emite n��mero vari��vel de ramos, de 2 a 10 ramos mediais e de 3 a 11 ramos laterais (35 vezes - 58,4%); ou cede de 3 a 8 ramos adicionais e ao n��vel da metade de seu percurso, na borda livre do ��rg��o, divide-se em um ramo medial e outro lateral (12 vezes - 20,0%); ou divide a irriga����o do ��rg��o com ramos denominados de complementares, 1 ramo (6 vezes - 10,0%) e 3 ramos (1 vez - 1,6%); ou ainda fornece os ramos medial e lateral, com predomin��ncia do lateral (3 vezes - 5,0%) ou do medial (3 vezes - 5,0%). Quanto �� distribui����o dos vasos penetrantes nos diferentes quadrantes, observamos que em mediana, por ordem, os test��culos direitos apresentam o maior n��mero de vasos penetrantes no quadrante craniomedial (13,0), seguido pelos quadrantes craniolateral (10,5), caudolateral (7,0) e caudomedial (6,5). Nos test��culos esquerdos, tamb��m o quadrante craniomedial mostra o maior n��mero de vasos penetrantes (12,5), seguido pelos quadrantes craniolateral (10,0), e com equival��ncia os quadrantes caudomedial e caudolateral (7,0). Anastomoses (8 vezes - 13,3%) foram localizadas todas na face ventral do ��rg��o. Comparando o n��mero de vasos penetrantes dos test��culos direitos e esquerdos, verificamos que n��o existem diferen��as estatisticamente significativas nos eq��inos da ra��a Puro-Sangue Ingl��s.

Proteina total, fracionamento eletrofor��tico e fibrinog��nio do sangue de caprinos confinados e em pastoeiro semi-extensivo

Conselho Nacional de Desenvolvimento Cient��fico e Tecnol��gico (CNPq)

Inqu��rito soroepidemiol��gico sobre a infec����o chag��sica em doadores de sangue na regi��o do Alto Parana��ba, Minas Gerais

This study aimed to evaluate the seroprevalence of Trypanosoma cruzi infection in blood donors of the core of Patos de Minas Regional Foundation's Hemominas, MG. To this end, tests were used (ELISA) and Reverse Passive Hemagglutination (HPR). Through retrospective study from 1996 to 2006, was considered the result of serological 21,787 donors where 259 (1.2%) were seropositive for T. cruzi infection and the highest number of seropositivity was found in the group of 41-50 years. The total number of donors tested, 15 143 (69.5%) were male and 6644 (30.5%) females giving a seroprevalence rate of 170 (0.8%) and 89 (0.4%) respectively. This seroepidemiological survey showed that still prevail rates of transmission of Chagas disease, which reinforces the idea of the need for serological tests for the prevention of Chagas disease, especially in endemic areas as the region of Triangulo Mineiro and Alto Paranaiba.

Efeitos do pentobarbital s��dico e do enfluorano sobre a circulação sangu��nea hep��tica: fluxometria eletromagn��tica e manometria (estudo experimental no c��o)

In 18 dogs, previously anesthetized with sodium pentobarbital for the surgical preparation, catheterism and monitoring, the action of sodium pentobarbital (7.5 mg/kg) and enflurane (1.5 - 2%) in the liver circulation was studied. Measurements of the following parameters were made in four different times, before and 15, 30 and 60 min after the drug administration. By direct determination: hepatic artery flow, portal vein flow, mean pressure of the abdominal aorta, peripheral arterial pressure (mean), pressure in the caudal cava vein, portal pressure; and by indirect determination: total flow, arterial-cava gradient, portal-cava gradient, resistance in the hepatic artery territory, resistance in the territory of the portal vein, and total resistance. Based on the results, it is concluded that in the experiment's conditions: sodium pentobarbital doesn't change significantly the hepatic circulation, and enflurance produces a fall in the total hepatic flow, by reducing the portal flow, without alterations of the hepatic arterial flow. It diminishes the total hepatic resistance by diminishing the arterial resistance without alterations of the portal resistance; it diminishes the arterial-cava gradient in consequence of the reduction of the abdominal aorta pressure and of the portal pressure, but it seems that the caudal cava pressure is not altered. It also occurs a fall in the peripheral mean pressure.

Dist��rbios neurol��gicos em trabalhadores com baixos n��veis de chumbo no sangue. I: Neuropatia perif��rica

This is a cross-sectional study with a randomized choice of individuals aiming at studying the validity of the Brazilian biological exposure limits applied to lead level in the blood (PbB) and delta-aminolevulinic acid in the urine (ALAU), which are 60 ��g/dl and 10 mg/g.creat., respectively. For this purpose, twenty workers, whose PbB and ALAU values have been below these limits over the past two years, were selected at random at a battery production plant in the State of S. Paulo, Brazil. The workers were submitted to a peripheral nerve conduction study. The results were compared with those obtained for workers of a control group also chosen at random. The lead workers showed a decrease in the velocity conduction of the radial nerves. Comparing this group with a randomized control group, a significant difference was observed (p-value = 0.0067). The results suggest that the Brazilian biological exposure limits above should be rearranged.

Dist��rbios neurol��gicos em trabalhadores com baixos n��veis de chumbo no sangue. II-Disfunc����es neurocomportamentais

This is a cross-sectional study with a randomized choice of individuals aiming at studying the validity of the Brazilian biological exposure limits applied to lead level in the blood (PbB) and delta-aminolevulinic acid in the urine (ALAU), which are 60 ��/dl and 10 mg/g.creat., respectively. Thus, twenty workers, whose PbB and ALAU values have been below these limits over the past two years, were selected at random at a battery plant in the State of S. Paulo, Brazil. The workers were submitted to a variation of the WHO Neurobehavioral Core Test Battery. The results were compared with those obtained for workers of a control group also chosen at random. The lead workers showed memory, mood and motor coordination disorders. Comparing these results with those obtained from the control group, a significant difference was observed (p-value < 0.02). The results indicate that the Brazilian biological exposure limits above should be reconsidered.

Genotipagem do locus ABO (9q34.1) em doadores de sangue da regi��o noroeste do estado de S��o Paulo

The advances of molecular genetics enabled us to understand the molecular basis of the ABO locus. Considering Us importance as a genetic marker and its applications, the aim of this study was to verify the distribution of the ABO genotypes in a Brazilian population from the Northwest region of the S��o Paulo Stale, Brazil. The genomic DNA was extracted from three hundred and twenty four healthy Brazilian blood donors (O ] 50; A 118; B 32 and AB 24) and analyzed by PCR amplification followed by restriction enzyme digestion. Fourteen genotypes were identified and the relative frequencies of the O , O , O , A and B genes ivere estimated at 44.6%, 16.9%, 4.1%, 25.3% and 9.1%, respectively. Tloese results demonstrate that the ABO locus presents a high polymorphism as revealed by molecular analysis.

Valores da Amplitude de Distribui����o do Tamanho dos Eritr��citos (RDW) em eq��inos Puro Sangue Ingl��s (PSI) submetidos a exerc��cios de diferentes intensidades

In order to evaluate the influence of exercise of different intensities on Red Blood Cell Distribution width (RDW) and Packed Cell Volume (VG) in Thoroughbred horses, blood was collected from 60 animals, 30 males and 30 females, subdivided in groups of horses with 24 to 36 months of age and not in training, and after 12 months of training, and horses with 36 to 48 months of age in training. Blood samples where collected before and after trot and gallop. Samples where analyzed with a automatic cell counter (Cell-Dyn 3500R, Abbott Diagnostic). Red Blood Cell Distribution width (RDW) values increased significantly after trot and gallop demonstrating a variation in the size of red blood cells, while Packed Medium Cell Volume (VGM) values did not show variations before or after exercise.

Circulação recente de sedimentos costeiros nas praias de santos durante eventos de tempestades: Dados para a gest��o de impactos f��sicos costeiros

The beachs of Santos are situated in Santos Bay, central portion of paulista coast, in S��o Paulo state. This beachs are frequently affected by cold fronts with winds and currents from the South. These fronts are responsible for the removal and transport of sediments (sand) in Santos beaches. In order to quantify this sedimentation the channels of Santos were analysed, due to their function as box colectors of sediments during storm events. The channels are filled by sands, which volume in channels 1 to 6 was estimated, by using the length, width and height of sand sedimented in the channels, in the event of 22-27 april 2005. The chanels 2, 3 and 1 presented the larger volumes of sands, confirming that the central and SW portion of the beaches of Santos present higher levels of sedimentation or re-sedimentation. That is due to the transport by ocean waves and currents and currents from the Channel of the Port of Santos. This central portion suffer invasion of marine water over street and buildings, caracterizated of geological rise area.

Significado da presen��a de esquiz��citos no sangue perif��rico de gestantes com pr��-ecl��mpsia

PURPOSE: to evaluate the significance of schizocytes presence in peripheral blood smear of pregnant women with pre-eclampsia, identifying and correlating them with other markers of hemolysis and of the disease severity. METHODS: Seventh six glass slides of peripheral blood smear of pregnant women with pre-eclampsia have been evaluated. After the smear, the slides have been stained with Leishman's dye and stored till they were examined with a Leica, model DLMB microscope, provided with the Qwin Lite 2.5 software that made it possible to record the images of selected fields in CD-ROM. Ten fields with approximately 100 erythrocytes were counted in each glass slide. Schizocytes (irregular fragment or helmet-shaped, bite-shaped or triangular) were considered as present, when their percentage was equal or higher than 0.2%, their presence being correlated with other hemolysis markers (hemoglobin, total bilirubin, lactic desidrogenasis and reticulocytes), pre-eclampsia markers (proteinuria and platelet number). The Statistical Package in Social Science for Windows (SPSS), 10.0 version has been used for statistical analysis, at p<0.05. RESULTS: schizocytes have been present in 31.6% of the pregnant women with pre-eclampsia. In most (75%) of the blood smears there have been three or four schizocytes. There has been no correlation between schizocyte presence and any other hemolysis marker, any pre-eclampsia marker or disease severity. CONCLUSIONS: schizocytes have been identified in a small number and in less than a third of the pregnant women with pre-eclampsia. There has been no correlation with other hemolysis marker parameters or with the disease severity. This way, the presence of schizocytes is not a marker of the clinical evolution of pre-eclampsia.

Log��stica, sistemas de movimento, fluxos econ��micos e intera����es espaciais no territ��rio Paulista: Uma abordagem para a geografia dos transportes e circulação

This work aims to express the production and consumption changes occurred in the State of S��o Paulo in line with the logistics, the systems of movement and the economic flows. The mentioned productive and consumption devolutions towards the interior just was possible in the fast rhythm, with the hierarchical combination of some basic elements, such as: 1) the logistics as strategy, planning and management (including in the concession of public services to the private enterprise) of transports, storage and communications; 2) the technological improvement of systems of movement (infrastructure and means of transportation) and 3) the economic flows (goods, services, informations, capital gains and people) in the territory. Thus, we go to an analysis of the impacts of the fifth logistics revolution and the alternatives between systems of movement and territorial fluidity in the service of corporative demands in the space pertaining to the State of S��o Paulo. �� Copyright Scripta Nova, 2009.

Exame eletrocardiogr��fico em equinos da ra��a puro sangue ��rabe submetidos ao exerc��cio em esteira de alta velocidade e �� suplementa����o com vitamina E

The effect of physical exercise, training and vitamin E supplementation on electrocardiographic parameters was evaluated in eight untrained Arabian mares, divided into two groups: control (n=4) and supplemented with vitamin E (n=4) at the daily dose of 1.000 UI. Animals were submitted to an incremental exercise test (P1) on high-speed treadmill inclined +7%, after that to a training period of 20 days and later to a new incremental exercise test (P2). Analysis and interpretation of electrocardiographic tracings were performed regarding the rhythm, heart rate, duration and amplitude of waves and intervals, before, immediately after and 30 min after the incremental exercise. A reduction of the rest heart rate was observed after training. There was no effect of vitamin E supplementation on electrocardiographic parameters. Results indicated that the electrocardiogram was efficient in detention of cardiac alterations promoted by the physical exercise, but more studies are needed to elucidate its clinical meaning.

Mau Funcionamento do Sistema de Circulação Extracorp��rea: Relato de Caso

Background and objectives: The introduction of extracorporeal circulation in clinical practice was decisive for the development of modern cardiovascular surgery. Addition of new procedures and equipment, however, brings inherent risks and complications. The objective of this report is to describe a malfunction of the oxygenation system and emphasize the importance of the interaction among the medical team members to prevent errors and complications. Case Report: During valve replacement and IVC correction surgery, we observed a darker shade of red in the blood on the exit of the oxygenator. Laboratory tests demonstrated severe acidosis and hypoxemia. The entire system was evaluated, but the cause of the malfunction was not found. Measures to reduce damage were successfully instituted. After the surgery, the whole system underwent technical evaluation. Conclusions: Interaction among the medical team members, early diagnosis, and immediate intervention were fundamental for a favorable outcome. �� 2011 Elsevier Editora Ltda.