Functional Capacity of Patients with Pacemaker Due to Isolated Congenital Atrioventricular Block

Background:Isolated congenital atrioventricular block (CAVB) is a rare condition with multiple clinical outcomes. Ventricular remodeling can occur in approximately 10% of the patients after pacemaker (PM) implantation.Objectives:To assess the functional capacity of children and young adults with isolated CAVB and chronic pacing of the right ventricle (RV) and evaluate its correlation with predictors of ventricular remodeling.Methods:This cross-sectional study used a cohort of patients with isolated CAVB and RV pacing for over a year. The subjects underwent clinical and echocardiographic evaluation. Functional capacity was assessed using the six-minute walk test. Chi-square test, Fisher's exact test, and Pearson correlation coefficient were used, considering a significance level of 5%.Results:A total of 61 individuals were evaluated between March 2010 and December 2013, of which 67.2% were women, aged between 7 and 41 years, who were using PMs for 13.5 ± 6.3 years. The percentage of ventricular pacing was 97.9 ± 4.1%, and the duration of the paced QRS complex was 153.7 ± 19.1 ms. Majority of the subjects (95.1%) were asymptomatic and did not use any medication. The mean distance walked was 546.9 ± 76.2 meters and was strongly correlated with the predicted distance (r = 0.907, p = 0.001) but not with risk factors for ventricular remodeling. (Arq Bras Cardiol. 2014; [online].ahead print, PP.0-0)Conclusions:The functional capacity of isolated CAVB patients with chronic RV pacing was satisfactory but did not correlate with risk factors for ventricular remodeling.

Cardiovascular Research Publications from Latin America between 1999 and 2008. A Bibliometric Study

Background:Cardiovascular research publications seem to be increasing in Latin America overall.Objective:To analyze trends in cardiovascular publications and their citations from countries in Latin America between 1999 and 2008, and to compare them with those from the rest of the countries.Methods:We retrieved references of cardiovascular publications between 1999 and 2008 and their five-year post-publication citations from the Web of Knowledge database. For countries in Latin America, we calculated the total number of publications and their citation indices (total citations divided by number of publications) by year. We analyzed trends on publications and citation indices over time using Poisson regression models. The analysis was repeated for Latin America as a region, and compared with that for the rest of the countries grouped according to economic development.Results:Brazil (n = 6,132) had the highest number of publications in1999-2008, followed by Argentina (n = 1,686), Mexico (n = 1,368) and Chile (n = 874). Most countries showed an increase in publications over time, leaded by Guatemala (36.5% annually [95%CI: 16.7%-59.7%]), Colombia (22.1% [16.3%-28.2%]), Costa Rica (18.1% [8.1%-28.9%]) and Brazil (17.9% [16.9%-19.1%]). However, trends on citation indices varied widely (from -33.8% to 28.4%). From 1999 to 2008, cardiovascular publications of Latin America increased by 12.9% (12.1%-13.5%) annually. However, the citation indices of Latin America increased 1.5% (1.3%-1.7%) annually, a lower increase than those of all other country groups analyzed.Conclusions:Although the number of cardiovascular publications of Latin America increased from 1999 to 2008, trends on citation indices suggest they may have had a relatively low impact on the research field, stressing the importance of considering quality and dissemination on local research policies.

Association Between Hemodynamic Profile, Physical Capacity and Quality of Life in Pulmonary Hypertension

Background: No studies have described and evaluated the association between hemodynamics, physical limitations and quality of life in patients with pulmonary hypertension (PH) without concomitant cardiovascular or respiratory disease. Objective: To describe the hemodynamic profile, quality of life and physical capacity of patients with PH from groups I and IV and to study the association between these outcomes. Methods: Cross-sectional study of patients with PH from clinical groups I and IV and functional classes II and III undergoing the following assessments: hemodynamics, exercise tolerance and quality of life. Results: This study assessed 20 patients with a mean age of 46.8 ± 14.3 years. They had pulmonary capillary wedge pressure of 10.5 ± 3.7 mm Hg, 6-minute walk distance test (6MWDT) of 463 ± 78 m, oxygen consumption at peak exercise of 12.9 ± 4.3 mLO2.kg-1.min-1 and scores of quality of life domains < 60%. There were associations between cardiac index (CI) and ventilatory equivalent for CO2 (r=-0.59, p <0.01), IC and ventilatory equivalent for oxygen (r=-0.49, p<0.05), right atrial pressure (RAP) and 'general health perception' domain (r=-0.61, p<0.01), RAP and 6MWTD (r=-0.49, p<0.05), pulmonary vascular resistance (PVR) and 'physical functioning' domain (r=-0.56, p<0.01), PVR and 6MWTD (r=-0.49, p<0.05) and PVR index and physical capacity (r=-0.51, p<0.01). Conclusion: Patients with PH from groups I and IV and functional classes II and III exhibit a reduction in physical capacity and in the physical and mental components of quality of life. The hemodynamic variables CI, diastolic pulmonary arterial pressure, RAP, PVR and PVR index are associated with exercise tolerance and quality of life domains.

Comparison of ACUITY and CRUSADE Scores in Predicting Major Bleeding during Acute Coronary Syndrome

Background:The ACUITY and CRUSADE scores are validated models for prediction of major bleeding events in acute coronary syndrome (ACS). However, the comparative performances of these scores are not known.Objective:To compare the accuracy of ACUITY and CRUSADE in predicting major bleeding events during ACS.Methods:This study included 519 patients consecutively admitted for unstable angina, non-ST-elevation or ST-elevation myocardial infarction. The scores were calculated based on admission data. We considered major bleeding events during hospitalization and not related to cardiac surgery, according to the Bleeding Academic Research Consortium (BARC) criteria (type 3 or 5: hemodynamic instability, need for transfusion, drop in hemoglobin ≥ 3 g, and intracranial, intraocular or fatal bleeding).Results:Major bleeding was observed in 31 patients (23 caused by femoral puncture, 5 digestive, 3 in other sites), an incidence of 6%. While both scores were associated with bleeding, ACUITY demonstrated better C-statistics (0.73, 95% CI = 0.63 - 0.82) as compared with CRUSADE (0.62, 95% CI = 0.53 - 0.71; p = 0.04). The best performance of ACUITY was also reflected by a net reclassification improvement of + 0.19 (p = 0.02) over CRUSADE’s definition of low or high risk. Exploratory analysis suggested that the presence of the variables ‘age’ and ‘type of ACS’ in ACUITY was the main reason for its superiority.Conclusion:The ACUITY Score is a better predictor of major bleeding when compared with the CRUSADE Score in patients hospitalized for ACS.

Evaluation of Electrocardiographic T-peak to T-end Interval in Subjects with Increased Epicardial Fat Tissue Thickness

Abstract Background: The association between periatrial adiposity and atrial arrhythmias has been shown in previous studies. However, there are not enough available data on the association between epicardial fat tissue (EFT) thickness and parameters of ventricular repolarization. Thus, we aimed to evaluate the association of EFT thickness with indices of ventricular repolarization by using T-peak to T-end (Tp-e) interval and Tp-e/QT ratio. Methods: The present study included 50 patients whose EFT thickness ≥ 9 mm (group 1) and 40 control subjects with EFT thickness < 9 mm (group 2). Transthoracic echocardiographic examination was performed in all participants. QT parameters, Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead electrocardiogram. Results: QTd (41.1 ± 2.5 vs 38.6 ± 3.2, p < 0.001) and corrected QTd (46.7 ± 4.7 vs 43.7 ± 4, p = 0.002) were significantly higher in group 1 when compared to group 2. The Tp-e interval (76.5 ± 6.3, 70.3 ± 6.8, p < 0.001), cTp-e interval (83.1 ± 4.3 vs. 76±4.9, p < 0.001), Tp-e/QT (0.20 ± 0.02 vs. 0.2 ± 0.02, p < 0.001) and Tp-e/QTc ratios (0.2 ± 0.01 vs. 0.18 ± 0.01, p < 0.001) were increased in group 1 in comparison to group 2. Significant positive correlations were found between EFT thickness and Tp-e interval (r = 0.548, p < 0.001), cTp-e interval (r = 0.259, p = 0.01), and Tp-e/QT (r = 0.662, p < 0.001) and Tp-e/QTc ratios (r = 0.560, p < 0.001). Conclusion: The present study shows that Tp-e and cTp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in subjects with increased EFT, which may suggest an increased risk of ventricular arrhythmia.

Nutrição mineral de hortaliças XXVII: tolerância de cultivares de tomateiro (Lycopersicon esculentum Mill) ao alumínio e ao manganês

Dois experimentos foram conduzidas, em condições de casa-de--vegetação com o objetivo de caracterizar diferenças entre cultivares de tomateiro (Lycopersvcum esculentum Mill) com relação à tolerância ao alumínio e ao manganês. No primeiro experimento foram cultivados em Latossol Roxo (solo ácido, com níveis elevados de alumínio e manganês), seis cultivares de tomateiro: "Santa Cruz Kada", "Angela IAC 3946", "Vital", "Roma VF", "Pavebo 220" e "Ronita N", os três primeiros de crescimento indeterminado e os restantes de crescimento determinado. No segundo experimento, os cultivares Santa Cruz Kada e Ronita N que apresentaram um contraste de desenvolvimento no solo ácido, foram cultivados em solução nutritiva de HOAGLAND & ARNON, modificada para níveis de manganês (0,5 ; 1,5 e 3,0 ppm) e com adição de níveis de alumínio (0,0; 10,0 e 20,00 ppm). Os resultados obtidos permitiram indicar o cultivar Santa Cruz Kada como mais tolerante ao alumínio que o cultuar Ronita N. A maior sensibilidade ao alumínio do cultivar Ronita N foi associada com uma maior exigência em cálcio e fósforo, com uma maior absorção de alumínio e também com efeito depressivo do alumínio na absorção dos nutrientes mencionados, em relação ao cultivar Santa Cruz Kada. A tolerância do cultivar Santa Cruz Kada ao alumínio apesar de ser maior que a do Ronita N pode ser considerada de grau relativamente baixo, podendo-se esperar ainda, boas respostas dessas plantas à calagem nos cultivares em solos ácidos. O comportamento dos cultivares frente aos níveis de manganês em solução nutritiva foi semelhante, não sendo observado qualquer efeito prejudicial do elemento nos níveis empregados.

Adubacão foliar de mudas de café (Coffea arabica, L., var. Mundo Nôvo) com três fontes de nitrogênio - 15N

O presente trabalho foi conduzido com a finalidade de se avaliar o efeito da aplicação foliar no nitrogênio em mudas de café (Coffea arabica L, var. Mundo Nôvo). Para isso, três fontes de fertilizantes nitrogenados - NaNO3, (NH4)2SO4 e (NH2)2CO - enriquecidos com 0,7, 0,6 e 0,4% de átomos de 15N em excesso, respectivamente, foram utilizados, aplicando-as de vários modos: 1) aplicação da dose total de cada fonte de nitrogênio ao solo; 2) aplicação da dose total de cada fonte exclusivamente foliar e 3) aplicação da metade desta dose total ao solo e da outra metade por via foliar, além das correspondentes testemunhas. O desenho experimental foi de blocos ao acaso, com 14 tratamentos e 3 repetições, com parte dos tratamentos em arranjo fatorial. As mudas de café, de 6 meses de idade foram cultivadas em casa de vegetação, durante um período de 7 meses. A seguir, as palantas foram separadas em frações raiz, caule e folha. Sobre estas frações, secas em estufa, pesadas e moídas, procedeu-se às análises químicas do nitrogênio e à determinação da relação isotópica 14N/15N. A produção de matéria seca, a quantidade de nitrogênio absorvido, aquela proveniente do solo e do fertilizante, por cada tratamento, em cada fração e na planta toda. foram utilizados para avaliar o efeito da adubação foliar ds fontes de nitrogênio. Pra a aplicação foliar do nitrogênio, foi construído um sistema espacial de pulverização. De acordo com os resultados obtidos são apresentadas, a continuação, as seguintes inferências. De maneira geral, a aplicação das três fontes de nitrogênio ao solo, seguida pela aplicação combinada ao solo e à folha, deram maior produção de matéria seca, não havendo diferença entre as fontes. Em relação a absorção do nitrogênio total, foi verificada uma maior absorção com a aplicação ao solo das três fontes de nitrogênio. No que diz respeito ao nitrogênio nas plantulas provenientes do fertilizante, a aplicação ao solo foi superior a aplicação foliar, para as três fontes. A porcentagem da eficiência do nitrogênio foi de 39%. Na aplicação foliar, a eficiência do nitrogênio foi 12,8%, 9,7% e 8,6% para nitrato de sódio, a uréia e o sulfato de amônio respectivamente. Na aplicação combinada, metade solo mais metade folha, a eficiência foi de 33,5%, 23,3% e 22,7% para o nitrato de sódio, o sulfato de amônio e a uréia, respectivamente. É difícil, no presente trabalho, explicar a pouca absorção do nitrogênio aplicada por pulverização foliar, destacando-se o nitrato de sódio em relação Ys outras fontes.

Efeito do ferro (59Fe) e do zinco (65Zn) e da natureza de três tipos de solos na produção de matéria seca e na composição química do feijoeiro (Phaseolus vulgaris L.) cv. carioca e na fixação de nitrogênio atmosférico por esta leguminosa

No presente trabalho, conduzido em casa de vegetação, procuramos estudar os efeitos dos micronutrientes ferro e zinco na produção de materia seca, composição química do feijoeiro (Phaseolus vulgaris L.) e na fixação do nitrogênio atmosférico, em três solos, classificados como Terra Roxa Estruturada (TRE), Latossol Vermelho Escuro (LVE) e Podzólico Vermelho Amarelo (PVA). Procuramos também determinar os índices de aproveitamento destes micronutrientes pelo feijoeiro e sua distribuição na parte aérea e na raiz. O delineamento experimental foi um fatorial 3x7, sendo três solos e sete tratamentos por solo, com três repetições. Nos tratamentos, foram utilizados duas doses de ferro e duas doses de zinco em separado ou combinando as doses menores e maiores destes micronutrientes (Fe1Zn1, Fe2Zn2). As doses de ferro foram 1,5 e 3,0 ppm e as de zinco foram 2,5 e 5,0 ppm. Foram aplicados 7,5 µCi de 59Fe/kg de solo nos vasos correspondentes à dose menor de ferro e 5,0 e 10,0 µCi de 65Zn/kg de solo nos vasos correspondentes respectivamente à dose menor e maior de zinco. Todos os tratamentos receberam uma adubação básica. O comportamento do feijoeiro apresentou grande variação entre os três tipos de solos, para todas as variáveis. Não houve influência dos tratamentos de ferro e zinco na produção de parte aérea e raiz e nem no peso e numero dos nodulos. A dose de 3,0 ppm de ferro diminuiu a capacidade dos nódulos de fixarem nitrogênio atmosférico em relação à dose de 1,5 ppm enquanto que a dose de 5,0 ppm de zinco aumentou esta capacidade, em relação à dose de 2,5 ppm. Houve um efeito significativo dos tratamentos na concentração de nitrogênio, potássio, ferro e zinco na parte aérea e na concentração de nitrogênio, e zinco na raiz. A absorção de zinco dos fertilizantes e a percentagem do zinco na planta proveniente do adubo foram influenciadas diretamente pelas doses de zinco. O maior coeficiente de aproveitamento do zinco do adubo foi de 4,0%.

Non root feeding with two sources of zinc on Coffea arábica L. 'mundo novo'(B.Rodr.) Choussy

A trial was carried out on an eight old coffee plantation with visible zinc problems. The plantation was situated nearly the city of Jaú (22º30'S, 48º30'W). State of São Paulo, Brazil. The soil is classified as medium texture Oxisol of low base saturation (Latossol Vermelho Amarelo - fase arenosa). The pulverization program started in november 1977, followed in march and July 1978 (heavy harvest) and ended in march and July 1979 (light harvest). Is should be mentioned that a well reconized characteristic of arábica coffe is its habit of biennial bearing, a very heavy harvest is most often followed by a light load the next year. The following treatments and amounts of chemicals per cova hole (4 trees) were tested in accordance with a random block design: 1. 1 g of zinc (zinc sulphate, 0.5%) 2. 3 g of nitrogen (urea, 1.3%) 3. 1 g of zinc + 3 g of nitrogen (zinc sulphate 0.5% + urea 1.3%) 4. 0.25 g, 0.50 g, 1.00 g, 2.00 g of zinc plus 0.75 g, 1.50 g, 3.00 g and 6.00 of nitrogen (correspondent to NZN* 15-0-0-5 as 0.75%, 1-5%, 3.0% and 6.0% by v/v). Foliar absorption data were obtained by collecting the 3rd and 4th pairs of the coffee leaves and analysed them for N, P, K, Ca, Mg, S, B, Cu, Fe, Mn, and Zn. The main results may be summarized as follows: 1. The maximum calculated yields of clean coffee were obtained by the applications of 5.84 1 of NZN (1.13%) per hectare. 2. The applications of zinc sulphate (0.5%) and urea (1.3%) together or separate did not affected the coffee bean production. 3. The applications of 15.0 1 of NZN per hectare reduced the coffee yields. 4. Leaf damages and burning symptoms were observed by the applications of urea (1.3%) plus zinc sulphate (0.5%) and larger doses than 7.5 1 of NZN per hectare. 5. Leaf tissue analysis show that the concentrations of the elements were affecred by the age of the leaves and by the yields of the coffee trees. 6. The applications of increasing doses of NZN causes an increase in the concentration of zinc, manganese and boron in the leaves and decreased the concentration in calcium and potassium the leaves. 7. The concentration of zinc in the leaves associated with the heavy harvest, in July, was 70.0 ppm.

Dr. H.G. Bronn's Klassen und Ordnungen des Thier-Reichs, wissenschaftlich dargestellt in Wort und Bild.

Bd 5; Abt 3; Buch 8