Value of ultrasonographic contrast in duplex scanning of leg arteries - Comparison with conventional duplex scanning and arteriography

Aim. Duplex scanning has been used in the evaluation of the aorta and proximal arteries of the lower extremities, but has limitations in evaluating the arteries of the leg. The utilization of ultrasonographic contrast (USC) may be helpful in improving the quality of the image in these arteries. The objective of the present study was to verify whether the USC increases the diagnostic accuracy of patency of the leg arteries and if it diminishes the time needed to perform duplex scanning.Methods. Twenty patients with critical ischemia (20 lower extremities) were examined by standard duplex scanning, duplex scanning with contrast and digital subtraction arteriography (DSA). The 3 arteries of the leg were divided into 3 segments, for a total of 9 segments per limb. Each segment was evaluated for patency in order to compare the 3 diagnostic methods. Comparison was made between standard duplex scanning and duplex scanning with contrast in terms of quality of the color-coded Doppler signal and of the spectral curve, and also of the time to perform the exams.Results. Duplex scanning with contrast was similar to arteriography in relation to patency diagnosis (p>0.3) and even superior in some of the segments. Standard duplex scanning was inferior to arteriography and to duplex scanning with contrast (p<0.001). There were improvements of 70% in intensity of the color-coded Doppler signal and 76% in the spectral curve after the utilization of contrast. The time necessary to perform the examinations was 23.7 minutes for standard duplex scanning and 16.9 minutes for duplex scanning with contrast (p<0.001).Conclusion. The use of ultrasonographic contrast increased the accuracy of the diagnosis of patency of leg arteries and diminished the time necessary for the execution of duplex scanning.

Influence of fluid volume variations on the calculated value of the left ventricular mass measured by echocardiogram in patients submitted to hemodialysis

The left ventricular mass (LVM) measurement is of major importance for renal patients, as ventricular hypertrophy is an important prognostic index. The echo-cardiogram of the ventricular mass is larger before than it is after hemodialysis, which can confuse data interpretation. The aim of this work is to study the influence of alterations in fluid volume on the variations in measurements of ventricular mass observed during the course of a hemodialysis. Sixteen patients with chronic renal insufficiency in hemodialysis were evaluated at the Dialysis Unit of the University Hospital-UNESP, Botucatu, São Paulo State. The left ventricular mass was calculated from echocardiograms taken before and after hemodialysis and simultaneous ultra-filtration (12 patients: UF GROUP) and before and after hemodialysis isovolemic phase with sequential ultra-filtration (10 patients: ISO GROUP). Six of these patients were submitted to measurements of left ventricular mass before and after hemodialysis in both isovolemic and simultaneous ultra-filtration procedures. In the UF group, there was significant reduction in the following parameters before and after dialysis: diastolic diameter from 54.0 +/- 6.0 mm to 45.6 +/- 7.6 mm; left ventricular mass from 342 +/- 114 g to 265 +/- 117 g; and its respective index (IMVE) from 214 +/- 68 g/m(2) to 168 +/- 71 g/m(2). The ISO group showed no statistically significant variation. The behavior of the variables of six patients submitted to both observations confirm these results. In conclusion, the variations in echocardiogram measurements of the left ventricular mass relating to hemodialysis appear to be induced by alterations of the volemic condition.

Exercise Training and Caloric Restriction Prevent Reduction in Cardiac Ca2+-Handling Protein Profile in Obese Rats

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effect of raloxifene on the vaginal epithelium of postmenopausal women

Objective: The objective was to analyze the effect of raloxifene oil the vaginal epithelium of postmenopausal women.Study design: In this non-randomized clinical trial, 80 women (mean age = 60.6 years) were prospectively studied. Forty patients received 60 mg/day of raloxifene (RG), and 40 women constituted it non-treated control group (CG), paired by age and time since menopause. The treated group consisted of patients with osteoporosis of the lumbar spine. Those with a diagnosis of infection ill the lower genital tract and using hormone therapy (HT) up to 6 months prior to the study were excluded. Vaginal smears were collected at baseline and after 6 months of intervention. The vaginal maturation value (VMV) was determined, and counts of superficial, intermediate and parabasal cells were performed. Smears were analyzed by only one cytopathologist who was blinded to patient data. The t-test, Wilcoxon test, and Chi-Squared test were used in the statistical analysis.Results: The study groups were homogeneous regarding age, time since menopause, parity, HT use, smoking, and body mass index. No statistically significant differences were observed in VMV median values (RG, 39.7 and 35.7; CG, 50.0 and 50.0, respectively) or in the percentage of superficial, intermediate and parabasal cells between the groups at baseline and after 6 months (p > 0.05). There was no significant correlation between VMV and age, time since menopause, previous HT use, or body mass index, in either of the groups.Conclusion: Treatment with raloxifene for 6 months has no effect on the maturation of the vaginal epithelium ill postmenopausal women with osteoporosis. (C) 2008 Elsevier B.V. All rights reserved.

Efficacy of the motile sperm organelle morphology examination (MSOME) in predicting pregnancy after intrauterine insemination

Background: Although the motile sperm organelle morphology examination (MSOME) was developed merely as a selection criterion, its application as a method for classifying sperm morphology may represent an improvement in the evaluation of semen quality. The aim of this study was to determine the prognostic value of normal sperm morphology using MSOME with regard to clinical pregnancy (CP) after intrauterine insemination (IUI).Methods: A total of 156 IUI cycles that were performed in 111 couples were prospectively analysed. Each subject received 75 IU of recombinant FSH every second day from the third day of the cycle. Beginning on the 10th day of the cycle, follicular development was monitored by vaginal ultrasound. When one or two follicles measuring at least 17 mm were observed, recombinant hCG was administered, and IUI was performed 12-14 h and 36-40 h after hCG treatment. Prior to the IUI procedure, sperm samples were analysed by MSOME at 8400x magnification using an inverted microscope that was equipped with DIC/Nomarski differential interference contrast optics. A minimum of 200 motile spermatozoa per semen sample were evaluated, and the percentage of normal spermatozoa in each sample was determined.Results: Pregnancy occurred in 34 IUI cycles (CP rate per cycle: 21.8%, per patient: 30.6%). Based on the MSOME criteria, a significantly higher percentage of normal spermatozoa was found in the group of men in which the IUI cycles resulted in pregnancy (2.6+/-3.1%) compared to the group that did not achieve pregnancy (1.2+/-1.7%; P = 0.019). Logistic regression showed that the percentage of normal cells in the MSOME was a determining factor for the likelihood of clinical pregnancy (OR: 1.28; 95% CI: 1.08 to 1.51; P = 0.003). The ROC curve revealed an area under the curve of 0.63 and an optimum cut-off point of 2% of normal sperm morphology. At this cut-off threshold, using the percentage of normal sperm morphology by MSOME to predict pregnancy was 50% sensitive with a 40% positive predictive value and 79% specificity with an 85% negative predictive value. The efficacy of using the percentage of normal sperm morphology by MSOME in predicting pregnancy was 65%.Conclusions: The present findings support the use of high-magnification microscopy both for selecting spermatozoa and as a routine method for analysing semen before performing IUI.

Transfusão de eritrócitos em crianças internadas em unidade de terapia intensiva pediátrica

JUSTIFICATIVA E OBJETIVOS: As indicações de transfusão de eritrócitos não estão bem estabelecidas em crianças gravemente enfermas. O objetivo deste estudo foi descrever a prática da transfusão de eritrócitos na UTI Pediátrica do Hospital de Clínicas da Universidade Estadual Paulista (HC-UNESP). MÉTODO: Estudo retrospectivo observacional realizado durante o ano de 2003. RESULTADOS: Setenta e cinco pacientes receberam transfusão, havendo registro de 105 indicações. Mais da metade dos pacientes (53,3%) tinha menos que um ano de idade. Taquipnéia (75,2%), palidez (65,7%) e hipotensão (51,4%) foram os registros mais freqüentemente observados antes da transfusão. Além disso, a gasometria evidenciou acidose metabólica (68,08%) e hipoxemia (63,8%). Dos 93 registros de valores de hemoglobina (Hb), 54 (58,1%) estavam entre 7 e 10 g/dL e dos 90 registros de hematócrito (Ht) observou-se que 66 (73,3%) apresentavam valores entre 21% e 30%. As principais indicações de transfusão foram anemia em 75 crianças (71,4%) e sangramento ativo em 26 (24,7%). O valor médio de Hb antes da transfusão foi de 7,82 ± 2,82 g/dL. Sete transfusões foram indicadas para pacientes com valores de Hb > 10 g/dL, crianças estas em pós-operatório imediato de intervenção cirúrgica cardíaca e casos de choque séptico. CONCLUSÕES: A transfusão de eritrócitos vem sendo utilizada criteriosamente, com indicações restritivas (Hb entre 7 e 10 g/dL). Nem sempre há anotação dos valores de Hb imediatamente antes da transfusão. A partir deste estudo, foi elaborado um protocolo de indicação de transfusão na unidade.

Using the current Brazilian value for the biological exposure limit applied to blood lead level as a lead poisoning diagnostic criterion

Tradicionalmente, os limites de tolerância biológica são utilizados exclusivamente para a promoção e a preservação da saúde dos trabalhadores, não sendo aplicados com fins diagnósticos. Entretanto, com relação a algumas intoxicações profissionais, o assunto é polêmico. Neste artigo, defende-se a utilização do limite de tolerância aplicado atualmente no Brasil à plumbemia como um critério importante para a realização do diagnóstico da intoxicação profissional pelo chumbo. Argumenta-se que, em oposição ao tradicional critério clínico, deve-se abordar o problema do diagnóstico da intoxicação pelo chumbo sob um ponto de vista epidemiológico, utilizando-se o atual valor do limite de tolerância para a plumbemia como um marcador de risco relativo significativamente aumentado.

Comparative study between trimetazidine and ice slush hypothermia in protection against renal ischemia/reperfusion injury in a porcine model

Purpose: The aim of the study was to compare the effects of renal ice slush hypothermia and the use of trimetazidine in the protection against ischemia/reperfusion (I/R) injury.Materials and Methods: Fifteen farm pigs were submitted to left kidney ischemia and right nephrectomy during the same procedure. Animals were divided into three groups. Group 1 was submitted to warm ischemia; Group 2 was submitted to cold ischemia with ice slush; and Group 3 received trimetazidine 20 mg one day and 4 hours before surgery. Ischemia time was 120 minutes in all three groups. Serum creatinine (SCr) and plasma iohexol clearance (CLioh) were measured before surgery and on postoperative days (PODs) 1,3,7, and 14. Semi-quantitative analyses of histological alterations were performed by a pathologist. A p value of < 0.05 was considered significant.Results: All groups showed elevation of serum creatinine in the first week. Serum creatinine was higher in Group 3 in the first and third postoperative days (Mean Cr: 5.5 and 8.1 respectively). Group 2 showed a lower increase in creatinine and a lower decrease in iohexol clearance than the others. Renal function stabilized in the fourteenth POD in all three groups. Analyses of histological alterations did not reach statistical significance between groups.Conclusion: Trimetazidine did not show protection against renal I/R injury in comparison to warm ischemia or hypothermia in a porcine model submitted to 120 minutes of renal ischemia.

Parametria da associação do midazolam ou diazepam em cães pré-tratados pela atropina e tratados pela dexmedetomidina e quetamina

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

Fermentation and nutritive value of silage and hay made from the aerial part of cassava (Manihot esculenta Crantz)

A mandioca, apesar de ser nativa do Brasil, ainda é sub-utilizada principalmente quando a questão é o aproveitamento da sua parte aérea. Com o objetivo de estudar o potencial da mandioca para alimentação animal, o presente trabalho avaliou as características da parte aérea da planta quando submetida os processos de ensilagem e fenação. Os tratamentos consistiram de: parte aérea ensilada sem emurchecimento (PAS); parte aérea ensilada após 24 horas de emurchecimento (PAE) e parte aérea fenada (PAF). As análises químicas foram realizadas a fim de avaliar os parâmetros que determinam o valor nutritivo da silagem e do feno. O emurchecimento elevou o teor de matéria seca de 25% no material in natura para 27.7%, sem alterar o teor de carboidratos solúveis (33.3 e 35.5% de MS na PAS e PAE respectivamente), bem como o poder tampão (204 mmol kg-1 MS na PAS e 195 mmol kg-1 MS na PAE). Nem o pH (3.57 na silagem in natura e 3.60 na PAE) nem os teores de NIDA (11.32% do nitrogênio total na MS na PAS e 9.99% do nitrogênio total na MS na PAE) diferiram entre as silagens, mas o NIDA foi maior na forragem fenada (15.39%). Contudo, o emurchecimento provocou aumento no nitrogênio amoniacal (de 6.5% do nitrogênio total na MS da PAS para 13.0 do nitrogênio total na MS da PAE). Os teores de ácidos graxos voláteis não sofreram alterações com o emurchecimento. O processo de ensilagem reduziu os teores de ácido cianídrico livre (HCN), sem, contudo, alterar a cianidrina.

Nutritive value of high and low tanin content of sorghum high moisture silage for horses

Foram utilizados oito cavalos castrados sem raça definida em delineamento inteiramente casualizado. O objetivo foi determinar o valor nutritivo das silagens de grãos de sorgo de baixo (SBT) e alto (SAT) teores de tanino na alimentação de equinos. Os tratamentos consistiram de duas dietas-teste compostas pelos grãos de sorgo ensilados (SBT e SAT), substituindo em 30% a MS da dieta-referência, constituída exclusivamente por feno. Os valores de digestibilidade dos nutrientes dos SBT e SAT apresentaram diferenças nos CDMS, CDMO, CDEB, CDPB e CDAmido em que SAT foi inferior (p < 0,05) para todos os parâmetros, em que os valores médios foram de, respectivamente, 79,53, 84,54, 79,36, 76,11 e 100% para SBT e 60,29, 64,47, 59,38, 44,63 e 97,06% para SAT. Concluiu-se que a utilização do SBT é promissora na nutrição de equinos, tornando-se alimento alternativo nas formulações de rações.

Evaluation of muscle tissue growth in Young Mediterranean Buffaloes slaughtered at different weights

This study evaluated muscle, adipose and bone tissue growth in young Mediterranean buffaloes slaughtered with different weights. Twenty eight non-castrated males, approximately 14 months old and 330 kilos, were distributed in four experimental and one control groups. Received the same diet during a non-fixed period and when reached the pre-established weights (450 kg, 480 kg, 510 kg, 540 kg) were fasted for 16 hours and slaughtered. NRC 1996, level 2, ruminal simulation program for non-castrated animals with a daily weight gain of 1.40 kg determined percentage composition of experimental diet (dry matter): coast cross hay (20.6%), corn silage (7.8%), cotton seed (8.2%), humid corn silage (46%) and commercial mineral concentrate (17.4%), representing 13% of crude protein and 2,68% of metabolizable energy (Mcal/kg). Feed was offered ad libitum twice daily. Slaughter of control group occurred after 30 days of an adaptation period. The other ones were weighted each 28 days until reached pre-established weight. Carcasses were chilled for 18 hours under -5 degrees C. Ninth, 10 degrees and 11 degrees ribs of the half left carcass were submitted to HH section and according to the statistical regression analysis (SAS, 1996), allometric coefficient value was negative (b<1) demonstrating the early growth of muscle in relation to empty carcass weight.

Chicken meat quality as a function of fasting period and water spray

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

Prognostic value of canine frozen-thawed semen parameters on in vitro sperm-oocyte interactions

Combining the data from conventional semen analysis with oocyte penetration assays should improve the assessment of the fertilizing ability of a semen sample. Thus, the objective of the present study was to evaluate the prognostic value of various semen parameters on the in vitro interactions between frozen-thawed canine sperm and homologous oocytes. Ten ejaculates from five stud dogs (two ejaculates/dog) were collected by digital manipulation. Semen samples were evaluated, extended in Tris-egg yolk-glycerol, frozen and stored in liquid nitrogen, and thawed several weeks later. Samples were evaluated for motility and sperm populations by computer-aided semen analysis (CASA), plasma membrane integrity (carboxy-fluorescein diacetate and propidium iodide), and sperm morphology (Bengal Rose). Thawed spermatozoa were also incubated with homologous oocytes for 18 h in an atmosphere of 5% CO2 and 95% air at 38 degrees C and sperm-oocyte interactions were evaluated. Simple linear regression models were calculated, with sperm parameters as independent variables and sperm-oocyte interactions as the dependent variable. There were significant associations between: percentage of oocytes bound to spermatozoa and beat cross frequency (BCF; R-2 = 63%); percentage of oocytes that interacted with spermatozoa and BCF (R-2 = 73%); and number of penetrated spermatozoa and velocity average pathway (VAP; R-2 = 64%) and velocity straight line (VSL; R-2 = 64%). Although plasma membrane integrity and sperm morphology had little prognostic value for in vitro interactions between canine frozen-thawed sperm and homologous oocytes, some motility patterns (evaluated by CASA) were predictive of in vitro sperm-oocyte interactions. (c) 2005 Elsevier B.V. All rights reserved.