Quilopericárdio idiopático primário: relato de caso

O acúmulo de quilo no espaço pericárdico ou quilopericárdio é uma condição que, com maior frequência, ocorre após trauma, cirurgia cardíaca e torácica ou associado a tumores, tuberculose ou linfoangiomatose. Quando não é possível a identificação precisa da etiologia, o quilopericárdio é denominado primário ou idiopático. Essa é uma situação clínica rara. Descrevemos um caso em paciente do sexo feminino, com 20 anos de idade, tratada cirurgicamente. A propósito do caso, apresentamos breve revisão da literatura e comentários sobre quadro clínico, etiopatogenia, exames diagnósticos complementares e opções de tratamento.

Anticoagulação oral em portadores de próteses valvares cardíacas mecânicas: experiência de dez anos

INTRODUÇÃO: Dados da literatura sugerem que as taxas de tromboembolismo e sangramento em pacientes com próteses valvares cardíacas mecânicas podem ser muito reduzidas se a terapia anticoagulante for otimizada. OBJETIVOS: Avaliar a ocorrência de complicações em portadores de próteses valvares cardíacas mecânicas submetidos à terapêutica anticoagulante, otimizada por meio de ambulatório especializado. MÉTODOS: Estudou-se a ocorrência de complicações ao longo de 10 anos em 261 pacientes com próteses valvares cardíacas mecânicas, anticoagulados e acompanhados em ambulatório especializado. Esses pacientes foram divididos em dois grupos conforme porcentual de consultas com tempo de protrombina (RNI) dentro do intervalo desejado: G1-0% a 50,00% e G2-50,01% a 100% das consultas. Foram avaliadas as ocorrências de complicações tromboembólicas e hemorrágicas na sua totalidade, ou subdivididas em maiores e menores, de acordo com a gravidade. Os resultados estão apresentados sob forma de estudo atuarial e de frequência linearizada de ocorrência de eventos. RESULTADOS: O estudo atuarial mostrou que, ao longo do tempo, no grupo G2 (com 50,01% a 100% das consultas com a RNI no intervalo desejado) maior número de pacientes esteve livre da ocorrência de qualquer tipo de evento, de eventos hemorrágicos menores ou da elevação exacerbada da RNI. As frequências linearizadas de ocorrência, em todos os tipos eventos, também foram menores nos pacientes do grupo G2. CONCLUSÕES: O tempo de permanência dentro do intervalo de anticoagulação desejado está diretamente relacionado com a ocorrência de complicações. Entretanto, mesmo com acompanhamento otimizado por meio de ambulatório especializado, apenas cerca de um terço dos pacientes apresentaram nível de anticoagulação adequado em mais da metade das consultas.

Involvement of L-Type Calcium Channel and SERCA2a in Myocardial Dysfunction Induced by Obesity

Obesity has been shown to impair myocardial performance. Nevertheless, the mechanisms underlying the participation of calcium (Ca2+) handling on cardiac dysfunction in obesity models remain unknown. L-type Ca2+ channels and sarcoplasmic reticulum (SR) Ca2+-ATPase (SERCA2a), may contribute to the cardiac dysfunction induced by obesity. The purpose of this study was to investigate whether myocardial dysfunction in obese rats is related to decreased activity and/or expression of L-type Ca2+ channels and SERCA2a. Male 30-day-old Wistar rats were fed standard (C) and alternately four palatable high-fat diets (Ob) for 15 weeks. Obesity was determined by adiposity index and comorbidities were evaluated. Myocardial function was evaluated in isolated left ventricle papillary muscles under basal conditions and after inotropic and lusitropic maneuvers. L-type Ca2+ channels and SERCA2a activity were determined using specific blockers, while changes in the amount of channels were evaluated by Western blot analysis. Phospholamban (PLB) protein expression and the SERCA2a/PLB ratio were also determined. Compared with C rats, the Ob rats had increased body fat, adiposity index and several comorbidities. The Ob muscles developed similar baseline data, but myocardial responsiveness to post-rest contraction stimulus and increased extracellular Ca2+ was compromised. The diltiazem promoted higher inhibition on developed tension in obese rats. In addition, there were no changes in the L-type Ca2+ channel protein content and SERCA2a behavior (activity and expression). In conclusion, the myocardial dysfunction caused by obesity is related to L-type Ca2+ channel activity impairment without significant changes in SERCA2a expression and function as well as L-type Ca2+ protein levels. J. Cell. Physiol. 226: 2934-2942, 2011. (C) 2011 Wiley-Liss, Inc.

Dinâmica Costeira dos Campos petrolíferos Macau/Serra, litoral setentrional do Estado do Rio Grande do Norte

This thesis describes the general behavior of the northern shore of the State of Rio Grande do Norte relating beach profile morphology with hydrodynamic and sedimentological parameters. The Macau and Serra Oil Field are inserted on this area and are under accelerated coastal erosion. At these oil fields are installed oil wells from PETROBRAS, nowadays located directly in the shoreline, under constant attacks of coastal processes (e.g. waves, tides and currents), which promote an intense morphodynamic variability of this sandy coast. The area was monitored for 24 months in three different stations (P01, P02 and P03). The methodology applied involved current techniques of beach profiles, hydrodynamical processes, remote sensing and geophysics. A synthesis of results obtained through the use of different time scales (monthly, lunar cycle, seasonal, annual) from a coastal dynamics study is presented. The average wind direction corresponded to 77ºAz (NE). The steepness of the berm and of the shoreface, as well as coastal current direction, do not present major changes, with an average of 36º for the steepness of the berm, 15º for the shoreface and 15º for the coastal current direction. This data set allows us to infer that the months of larger coastal erosion were November/2000 and April/2001, because of the largest wave parameter during this time. The months of worse coastal erosion in this area are related with the increasing wavy energy. This in turn, seems to be related to seasonal climatic variations, with the wave energy and tide currents speed increasing during months of minor precipitations (June to January). The months of worse coastal erosion were September and November, when the largest wave parameters and speed currents are measured in the area. Since these months are included on the period of minor precipitations, we related the coastal erosion to seasonal climatic variations. The results obtained during these 24 months of monitoring confirms a situation of accentuated erosion, mainly in Profile 03 (Barra do Corta-Cachorro), where the wave height, period, and coastal current speed are always larger than the values found in Profile 02 (Macau5). Probably these values are more expressive in Profile 03, because it does not present any natural structure of protection against the wave impacts, as the barrier island located at Ponta do Tubarão, or the sand banks in front of Macau5. The transport of the sediments occurs from East to West, and the sand accumulation is more pronounced on Profile 03 intertidal zone, where there are embrionary dunes in dryer months. The tidal currents speed, on the other hand, is more accentuated in the Macau5 area (Profile 02). At Ponta do Tubarão, the tidal currents presented a preferential direction for NE, at times of flood, currents and for NW, at times of ebb current; at Barra do Corta-Cachorro the direction of the currents were predominantly for NW, independent of the tide phase, coinciding with the preferential direction of the longshore current. This currents inversion at Ponta do Tubarão is attributed to the presence of the Ponta do Tubarão island barrier and by the communication channel of the lagoon with the sea. The tide currents are better observed in protected areas, as in the Ponta do Tubarão, when they present inversion in their direction accordingly to the flood and ebb tide. In open areas, as in Barra do Corta-Cachorro, the tide currents are overprinted by the longshore currents. Sediment analysis does not show important modifications in grain size related to seasonality (dry- and rainy seasons). On the foreshore and backshore zones, the sediments vary from fine to medium sand, while in the shoreface they very from fine to very sands. The grains are mostly spheres, varying from sub rounded to sub angled. Quartz is the main component alongside Feldspat and heavy minerals as accessory components. Biogenic content is also present and mainly represented by mollusks fragments. The calculated sediment transport show values around 100 m3/day. The morphodynamic studies indicated that this is a reflexive area from October to April, and intermediate from May to September. The Relative Tide Range-RTR for this area is 4 < RTR < 15, and so classified in the mixed wave-tide group. Having this exposed we can affirm that the more active natural factors in this area are the currents, followed by the tides and the winds. The anthropic factors are exclusively local and punctual (Macau and Serra Oil Field). Taking in account the economic importance of the area, as well as the intensity of coastal processes acting on this shore, it is important a continuity of the monthly environmental monitoring looking for variations on longer-period cycles. These data have been stored on the geo-referenced database of the projects MARPETRO and PETRORISCO (REDE 05), aiming to model the coastal and sea environment, susceptible to oil spills and their derivatives

Litoestratigrafia e deformação cenzóica na região de Icapuí, Ceará, e implicações para a estruturação de campos de petróleo na borda ocidental da bacia Potiguar(NE do Brasil)

This thesis deals with the sedimentological/stratigraphic and structural evolution of the sedimentary rocks that occur in the NW continental border of the Potiguar Basin. These rocks are well exposed along coastal cliffs between the localities of Lagoa do Mato and Icapuí, Ceará State (NE Brazil). The sedimentological/stratigraphic study involved, at the outcrop scale, detailed facies descriptions, profile mapping of the vertical succession of different beds, and columnar sections displaying inferred lateral relationships. The approach was complemented by granulometric and petrographic analyses, including the characterization of heavy mineral assemblages. The data set allowed to recognize two kinds of lithological units, a carbonate one of very restricted occurrence at the base of the cliffs, and three younger, distinct siliciclastic units, that predominate along the cliffs, in vertical and lateral extent. The carbonate rocks were correlated to the late Cretaceous Jandaíra Formation, which is covered by the siliciclastic Barreiras Formation. The Barreiras Formation occurs in two distinct structural settings, the usual one with nondeformed, subhorizontal strata, or as tilted beds, affected by strong deformation. Two lithofacies were recognized, vertically arranged or in fault contacts. The lower facies is characterized by silty-argillaceous sandstones with low-angle cross bedding; the upper facies comprises medium to coarse grained sandstones, with conglomeratic layers. The Tibau Formation (medium to coarse-grained sandstones with argillite intercalations) occurs at the NW side of the studied area, laterally interlayered with the Barreiras Formation. Eolic sediments correlated to the Potengi Formation overly the former units, either displaying an angular unconformity, or simply an erosional contact (stratigraphic unconformity). Outstanding structural features, identified in the Barreiras Formation, led to characterize a neocenozoic stress field, which generated faults and folds and/or reactivated older structures in the subjacent late cretaceous (to paleogene, in the offshore basin) section. The structures recognized in the Barreiras Formation comprise two distinct assemblages, namely a main extensional deformation between the localities of Ponta Grossa and Redonda, and a contractional style (succeeded by oblique extensional structures) at Vila Nova. In the first case, the structural assemblage is dominated by N-S (N±20°Az) steep to gently-dipping extensional faults, displaying a domino-style or listric geometry with associated roll-over structures. This deformation pattern is explained by an E-W/WNW extension, contemporaneous with deposition of the upper facies of the Barreiras Formation, during the time interval Miocene to Pleistocene. Strong rotation of blocks and faults generated low-angle distensional faults and, locally, subvertical bedding, allowing to estimate very high strain states, with extension estimates varying between 40% up to 200%. Numerous detachment zones, parallel to bedding, help to acommodate this intense deformation. The detachment surfaces and a large number of faults display mesoscopic features analoguous to the ones of ductile shear zones, with development of S-C fabrics, shear bands, sigmoidal clasts and others, pointing to a hydroplastic deformation regime in these cases. Local occurrences of the Jandaíra limestone are controled by extensional faults that exhume the pre-Barreiras section, including an earlier event with N-S extension. Finally, WNWtrending extensional shear zones and faults are compatible with the Holocene stress field along the present continental margin. In the Vila Nova region, close to Icapuí, gentle normal folds with fold hinges shallowly pluging to SSW affect the lower facies of the Barreiras Formation, displaying an incipient dissolution cleavage associated with an extension lineation at high rake (a S>L fabric). Deposition of the upper facies siliciclastics is controlled by pull-apart graben structures, bordered by N-NE-trending sinistral-normal shear zones and faults, characterizing an structural inversion. Microstructures are compatible with tectonic deformation of the sedimentary pile, burried at shallow depths. The observed features point to high pore fluid pressures during deformation of the sediments, producing hydroplastic structures through mechanisms of granular flow. Such structures are overprinted by microfractures and microfaults (an essentially brittle regime), tracking the change to microfracturing and frictional shear mechanisms accompanying progressive dewatering and sediment lithification. Correlation of the structures observed at the surface with those present at depth was tested through geophysical data (Ground Penetrating Radar, seismics and a magnetic map). EW and NE-trending lineaments are observed in the magnetic map. The seismic sections display several examples of positive flower structures which affect the base of the cretaceous sediments; at higher stratigraphic levels, normal components/slips are compatible with the negative structural inversion characterized at the surface. Such correlations assisted in proposing a structural model compatible with the regional tectonic framework. The strong neogenepleistocene deformation is necessarily propagated in the subsurface, affecting the late cretaceous section (Açu and Jandaíra formations), wich host the hydrocarbon reservoirs in this portion of the Potiguar Basin. The proposed structural model is related to the dextral transcurrent/transform deformation along the Equatorial Margin, associated with transpressive terminations of E-W fault zones, or at their intersections with NE-trending lineaments, such as the Ponta Grossa-Fazenda Belém one (the LPGFB, itself controlled by a Brasiliano-age strike-slip shear zone). In a first step (and possibly during the late Cretaceous to Paleogene), this lineament was activated under a sinistral transpressional regime (antithetic to the main dextral deformation in the E-W zones), giving way to the folds in the lower facies of the Barreiras Formation, as well as the positive flower structures mapped through the seismic sections, at depth. This stage was succeeded (or was penecontemporaneous) by the extensional structures related to a (also sinistral) transtensional movement stage, associated to volcanism (Macau, Messejana) and thermal doming processes during the Neogene-Pleistocene time interval. This structural model has direct implications to hydrocarbon exploration and exploitation activities at this sector of the Potiguar Basin and its offshore continuation. The structure of the reservoirs at depth (Açu Formation sandstones of the post-rift section) may be controlled (or at least, strongly influenced) by the deformation geometry and kinematics characterized at the surface. In addition, the deformation event recognized in the Barreiras Formation has an age close to the one postulated for the oil maturation and migration in the basin, between the Oligocene to the Miocene. In this way, the described structural cenario represents a valid model to understand the conditions of hydrocarbon transport and acummulation through space openings, trap formation and destruction. This model is potentially applicable to the NW region of the Potiguar Basin and other sectors with a similar structural setting, along the brazilian Equatorial Atlantic Margin

Análise multitemporal dos elementos geoambientais da região da Ponta do Tubarão, área de influência dos campos petrolíferos de Macau e Serra, município de Macau/RN

The study area is inserted in Ponta do Tubarão region, Macau City, setentrional littoral of Rio Grande do Norte State, composed of Tertiary and Quatemary sedimentary rocks and sediments. This region is characterized for the intense action of the coastal processes, causing the morphologic instability in part of the area, beyond the interference of human activities, as the Petroliferous Industrial Polo, salt companies and shrimp farms. This justifies the integration of multidisciplinary and multitemporal detailed scientific studies dealing with the evaluation of the changing behavior of this coastal environment by geoenvironments elements characterization, identifying protected and recuperation areas, mainly those under socioeconomic intervention. The main objective was the coastal monitoring using geoprocessing techniques to prepare thematic maps useful for oil spilling environment risk areas survey. The methodology was based on multitemporal interpretation of remote sensing images and field checking, integrated in a Geographical Information System (GIS). The Geologic, Geomorphologic, Vegetation, Soil and Land Use maps were prepared, and later on they allowed the generation of the Natural Vulnerability and Environmental Vulnerability maps. These maps had been classified in accordance with vulnerability degrees: very low, low, medi um, high and very high. Beyond these maps the GIS allowed the analysis of the shoreline evolution for 10 distinct dates, using Landsat 5 TM and 7 ETM+ and SPOT-HRVIR images. This analysis made possible the attendance of the coastal morphodynamic evolution, where the results had been represented by areasof erosion and accretion (or deposition) of sediments, pointing critical areas under erosive process to the petroliferous industry (Macau and Serra fields). The GIS also provided to prepare the Environmental Sensitivity Maps of Oil Spill (SAO Maps) in operational scale (1: 10.000), according to the norms ofthe Ministério do Meio Ambiente (MMA 2002). The SAO Map in operational scale was based on IKONOS images mosaic where the ESI (Environmental Sensitivity Index) was represented according with two tides phases of theregion. Therewere recognizedfiveESI (3, 4,7,9, 1O) for the low tide; to the high tide the ESI number increased to seven (3, 4, 5, 7, 8, 9, 10). All these information are necessary to the decisions making about oi! spill and its derivatives containment. These techniques application makes possible the optimization and implantation ofnew socioeconomics activities of low environmental impact, indicates areas for better productivity and security exploration, and benefits local communities with fauna and flora preservation. The development of these activities is inserted in the scope of Monitoramento Ambiental de Áreas de Risco a Derrames de Petróleo e Seus Derivados Cooperation Project (Rede 05/01 - PETRORISCO, FINEP/CTPETRO/PETROBRAS) of multidisciplinary and interinstitucional characteristics dealing with subjects involving the environmental monitoring and the petroliferous activity

Dinâmica da paisagem no litoral oriental do Rio Grande do Norte: geocartografia e padrões espaciais dos campos de dunas móveis

This study shows the results of a research developed in the coastal regions of the Maxaranguape and Touros municipalities, more specific in the mobile dune fields of the Rio Grande do Norte's eastern coast. Although the coastal zones, represent a small percentage of the earth's surface it concentrates a great part of the world's population. The Rio Grande do Norte's state coastal landscape mosaic composed by the dune fields suggest a dynamic scene of changes in the spatial and temporal arranges, with significant changes in the geometry of the sedimentary cover. Following this perspective this research has the objective to map the emerged coastal zone of the Rio Grande do Norte's eastern coast under the perspective of the time-space evolution of the mobile dune fields using geoprocessing techniques, which includes remote sensing, digital images processing and geographic information system (GIS). The results imply the issue of thematic maps: Geologic map; multitemporal evolution map of the mobile dune fields; quantification of the mobile dune fields differences map; temporal evolution of the mobile dune fields surrounds map. The El Niño episodes have directly affected the atmospheric circulation, what have enhanced the sedimentary input in the sand dune, what can justify the relative area growth between the years of 1993 and 2001. The dynamic of the landscape transition were higher than the stability of the spatial pattern of the dune and it's surrounds, as a result the Rio Grande do Norte eastern coast dune fields, specially the mobile dunes from Touros, Zumbi and Maracajau have shown a decrease on the sedimentary cover without vegetation area from 1970 to 2007. Therefore, the data acquired and the techniques used, can be, eventually applied to the mobile dune fields monitoring in order to preserve the dune ecosystems in the Rio Grande do Norte coast

Massa paranasal: dacrioestenose congênita? Relato de caso

O objetivo deste é descrever uma criança portadora de massa paranasal, atentando para a importância dos diagnósticos diferenciais. RELATO do CASO: ACS, 6 meses, sexo feminino, desde o nascimento apresentando abaulamento não inflamatório, no canto medial do olho esquerdo, lacrimejamento e hiperemia no olho direito. Ao exame apresentava fenômeno de Bell negativo bilateral, lagoftalmo à direita, ulceração e opacidade corneana à direita; presença de lesão arredondada, de superfície lisa no canto medial do olho esquerdo, sem sinais inflamatórios, medindo aproximadamente 2 cm de diâmetro, não pulsátil. À palpação, a lesão era elevada, de consistência fibroelástica, imóvel, indolor, irredutível. À propedêutica das vias lacrimais, não havia refluxo à compressão, o teste de Milder foi negativo em ambos olhos e as vias apresentavam-se pérvias à dacriocistografia. O exame tomográfico revelou tratar-se de meningocele fronto-etmoidal. COMENTÁRIOS: Os autores chamam a atenção para a adequada semiologia para a investigação das massas paranasais, a fim de se instituir o adequado tratamento.

Prostaglandin E-2 production by high and low virulent strains of Paracoccidioides brasiliensis

The production of prostaglandins (PGs) during fungal infections could be an important suppressor factor of host immune response. Host cells are one source of prostaglandin E-2 (PGE(2)); however another potential source of PGE(2) is the fungal pathogen itself. Thus, both host and fungal PGE2 production is theorized to play a role in pathogenesis, being critical for growth of the fungus and to modulate the host immune response. The purpose of this work was to investigate if high and low virulent strains of Paracoccidioides brasiliensis have the capacity to produce PGE(2) in vitro, and if this production was related to the fungal growth. The results demonstrated that both strains of P. brasiliensis produce high levels of PGE(2) and the treatment with indomethacin, a cyclooxygenase inhibitor, significantly reduced the production of this mediator, as well as the viability of the fungus. Thus, our data indicate that PGE(2) is produced by P. brasiliensis by a cyclooxygenase-dependent metabolic pathway, and its production is required for fungal survival. This discovery reveals an important factor that has potentially great implications for understanding the mechanisms of immune deviation during infection.

Cytotoxicity of Portland Cement with Different Radiopacifying Agents: A Cell Death Study

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Treatment of experimental periodontal disease with antimicrobial photodynamic therapy in nicotine-modified rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Paracoccidioides brasiliensis Uses Endogenous and Exogenous Arachidonic Acid for PGE(x) Production

Paracoccidioides brasiliensis is the agent of paracoccidioidomycosis, the most prevalent deep mycosis in Latin America. Production of eicosanoids during fungal infections plays a critical role on fungal biology as well as on host immune response modulation. The purpose of our study was to assess whether P. brasiliensis strains with different degree of virulence (Pb18, Pb265, Bt79, Pb192) produce prostaglandin E-x (PGE(x)). Moreover, we asked if P. brasiliensis could use exogenous sources of arachidonic acid (AA), as well as metabolic pathways dependent on cyclooxygenase (COX) enzyme, as reported for mammalian cells. A possible association between this prostanoid and fungus viability was also assessed. Our results showed that all strains, independently of their virulence, produce high PGE(x) levels on 4 h culture that were reduced after 8 h. However, in both culture times, higher prostanoid levels were detected after supplementation of medium with exogenous AA. Treatment with indomethacin, a COX inhibitor, induced a reduction on PGEx, as well as in fungus viability. The data provide evidence that P. brasiliensis produces prostaglandin-like molecules by metabolizing either endogenous or exogenous AA. Moreover, the results suggest the involvement of these mediators on fungal viability.

Production of leukotriene B4 by Paracoccidioides brasiliensis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Short-term changes caused by fire and mowing in Brazilian Campos grasslands with different long-term fire histories

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)