Anestesia em paciente obstétrica portadora de anemia falciforme e traço talassêmico após plasmaféresis: relato de caso

JUSTIFICATIVA E OBJETIVOS: A plasmaféresis é a técnica de tratamento de escolha para pacientes com anemia hemolítica grave. Uma de suas conseqüências é a depleção de colinesterase plasmática, o que interfere na metabolização de alguns bloqueadores neuromusculares de uso corrente na prática anestesiológica. RELATO do CASO: Paciente com 26 anos, estado físico ASA IV, gestação de 30 semanas e 3 dias, portadora de anemia falciforme, traço talassêmico e alo-imunização para antígenos de alta freqüência. Apresentou crise de falcização, sendo transfundida com derivado sangüíneo incompatível. Evoluiu com hemólise maciça, sendo admitida com hemoglobina de 3 g/dL e hematócrito de 10%, icterícia intensa, taquicardia, apatia e descoramento. Na avaliação hematológica concluiu-se ser situação de inexistência de sangue compatível para transfusão. Foi tratada com corticoterapia, imunoglobulinas e plasmaféresis. No segundo dia de internação, evoluiu com insuficiência renal aguda e edema pulmonar agudo, piora do estado geral e instabilidade hemodinâmica. Indicada a resolução da gestação em decorrência do quadro clínico da paciente e do sofrimento fetal agudo que se sobrepôs. A paciente foi admitida na sala de operações consciente, dispnéica, pálida, ictérica, SpO2 de 91% em ar ambiente, freqüência cardíaca de 110 bpm e pressão arterial de 110 x 70 mmHg, em uso de dopamina (1 µg.kg-1.min-1) e dobutamina (10 µg.kg-1.min-1). Optou-se por anestesia geral balanceada, com alfentanil (2,5 mg), etomidato (14 mg) e atracúrio (35 mg) e isoflurano. Não se observou intercorrências anestésico-cirúrgicas. Ao final, a paciente foi encaminhada à UTI, sob intubação orotraqueal, e em uso de drogas vasoativas, tendo sido extubada após 3 horas. CONCLUSÕES: Este caso mostrou-se um desafio para a equipe, visto que a paciente apresentava instabilidade hemodinâmica e alteração do coagulograma, condições que contra-indicam a anestesia regional; além disto, a plasmaféresis potencialmente depleta os estoques de colinesterases plasmáticas, o que interfere na anestesia. Entretanto, o arsenal medicamentoso disponível permitiu o manuseio seguro desta situação.

Usos potenciais de moringa oleifera lam., uma matriz para produção de biodiesel e tratamento de água no semiárido nordestino

The current environmental crisis demands transformations in the relations among society, nature and development, considering sustainability. In this context, an important theme is replacing fossil fuels with biofuels, such as biodiesel. Moringa oleifera Lam. is a species that can be used as a raw material to produce biodiesel. Besides, it is a multiple purposes plant, which can be used also in water treatment. Thus, the aims of this work were to analyze the anatomical adaptations found in the stem and in the leaf and the seed s oil stores of M. oleifera., to investigate chemical characteristics of M. oleifera s seed oil, considering biodiesel production, and to evaluate the coagulation activity of these seeds in water treatment. Semipermanent histological laminas were made and it follows that the stem has thick cuticle, stomata whose cells guard are below the epidermis line, hollow medulla, druses and tector trichomes as adaptations to climate and soil conditions in which the species is found and the leaf is dorsiventral and it has thick cuticle, tector trichomes and druses. The seed has great reserves of oil. These features favor the use of Moringa oleifera Lam. as a raw material to produce biodiesel in Brazil s Northeast semiarid region. Chemical analysis were made through oil solvent extraction using mechanic stirrer. The oil was analyzed in UV spectrophotometer. A transesterification was made and biodiesel was analyzed in gas chromatography. Oil yield was high and good quality biodiesel was obtained. To evaluate seeds coagulantion activity, coagulation and flocculation essays in jartest were made, using seed extract to treat raw water. Seeds were efficient in cogulation process to treat water. So, they can be used in rudimentary systems or as a raw material to coagulant proteins extraction, as an alternative to traditional coagulants. M. oleifera has characteristics that favor its use to biodiesel production and water treatment

Reserva extrativista do Rio Cajari: verso e reverso da territorialização no sul do Amapá

The creation of Extractive Reserves (RESEX s) emerges from the resistence movement of the forest people and represents an alternative administration of the naturel resources in the from of Conservation Units (UC). From the institutional point of view the RESEX s are UC s of direct use belong of the Brazilian State, which concedes the right of use to resident families through a legal concession, uhich in based an the principle of coadministration between state and community. The use of these areas is based on the paradigm of sustainable development. In the Extractive Reserve of Rio Cajari over time there has been an experience of confliting interests between the big capital and the local population, which led to noticiable changes of lifestyle of the rural extrativist. In this sense the essay Extractive Reserve of Rio Cajari: various aspects of land use and awnership in southem Amapa , wants to analyse the nuances in which the land grabbing happened and how it affected the day to day of life its in habitants

Short- and long-term reproductive effects of prenatal and lactational growth restriction caused by maternal diabetes in male rats

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

Estudo Longitudinal, Bioquímico e Histoquímico, de Placentas de Ratas Diabéticas: Relação com a Macrossomia e o Retardo de Crescimento Intra-uterino

Objetivo: o estudo longitudinal, entre o 18º e o 21º dias de prenhez, das alterações bioquímicas e histoquímicas das placentas de ratas diabéticas, cujos fetos tiveram macrossomia e retardo de crescimento intra-uterino (CIUR). Material e Método: usando modelo experimental em ratas, foram estudados 3 grupos: controle, diabete moderado e grave. A prenhez foi resolvida por cesárea no 18º ou no 21º dia. Compararam-se as glicemias materna e fetal; a incidência de recém-nascidos (RN) de peso pequeno (PIP), adequado (AIP) e grande (GIP) para tempo de prenhez; peso, índice e conteúdo de DNA, RNA e proteínas placentários e quantidade de glicogênio na superfície de trocas materno-fetais. Resultados: no diabete moderado houve maior proporção de RN-GIP com placentas ricas em DNA e diminuição progressiva de glicogênio em suas membranas no final da prenhez. No diabete grave houve predomínio de RN-GIP e as placentas exibiram menor conteúdo de DNA, síntese aumentada de RNA e tendência a maior produção protéica, com manutenção dos depósitos de glicogênio. Conclusões: concluiu-se que, entre o 18º e o 21º dias, os desvios do crescimento fetal no diabete materno, moderado e grave relacionam-se a alterações placentárias distintas. No moderado há apenas hiperplasia celular, com desaparecimento do glicogênio no final da prenhez. No grave, a superfície de trocas materno-fetais é mais espessada e, além de hiperplasia, há hipertrofia das células, com manutenção dos estoques placentários de glicogênio.

Dietas vegetarianas e desempenho esportivo

As evidências atuais apontam benefícios da dieta vegetariana para a saúde humana. Contudo, a partir da adoção de práticas vegetarianas mais restritivas, confirmam-se os riscos à saúde. As dietas vegetarianas são caracterizadas pelo elevado consumo de carboidratos, fibras, magnésio, potássio, folato e antioxidantes, podendo apresentar deficiências em aminoácidos e ácidos graxos essenciais, cálcio, zinco, ferro e cobalamina. Pesquisas experimentais em humanos indicam que vegetarianos e não-vegetarianos apresentam capacidade aeróbica semelhante. em relação ao desempenho em atividades de força e potência muscular, as pesquisas são escassas, mas as existentes não apontam diferenças significativas. Situações de risco cardiovascular têm sido confirmadas, devido ao provável quadro de hiperhomocisteinemia, em decorrência da baixa ingestão de cobalamina. As dietas vegetarianas são isentas de creatina, o que resulta em estoques musculares mais baixos nessa população. Possivelmente ocorrem alterações hormonais e metabólicas em resposta às dietas vegetarianas, como baixos níveis de testosterona e androstenediona. A função imune parece não ser prejudicada. Dessa forma, a prática de dietas vegetarianas apresenta-se compatível com a prática esportiva cotidiana, desde que bem planejada para evitar deficiências nutricionais.

Gonadic Sperm Reserve in Buffaloes Created under Tropical Conditions

The objective of the present study was quantifying the spermatic production per gram and daily rate of the testicular parenchyma. Testis of 12 crossbred Murrah buffaloes aged 24 to 48 months created under extensive conditions in the State of São Paulo/Brazil were analyzed. Animals were divided into groups based on the testicular shape (long and long-moderate) and testicular sides (right and left) and the studied parameters were: length and testicular width, weight and volume of the albuginea and mediastinum and net weight of the testicular parenchyma, gonadic sperm reserves, spermatic production/g of testicular parenchyma, daily spermatic production/g, total daily spermatic production, resulting into the values: 8.16 +/- 0.87 and 4.29 +/- 0.50 cm; 9.09 +/- 1.91 g and 8.77 +/- 1.88 mL; 0.97 +/- 0.39 g and 0.90 +/- 0.38 mL; 112.91 +/- 18.85 g; 14.32 x 10(9) +/- 0.15; 13.42 x 10(6) +/- 0.17; 27.40 x 10(6) +/- 0.35 and 2.92 x 10(9) +/- 0.30, registering no difference between right and left testis in relation to the parameters (P>0.05). There was no relation between testicular biometry and spermatic production (P>0.05). According to the obtained values, all animals were considered sexually mature and presented an efficient spermatic production per gram of testicular parenchyma and total daily production.

Fruit and seed ontogeny related to the seed behaviour of two tropical species of Caesalpinia (Leguminosae)

Caesalpinia echinata and C ferrea var. ferrea have different seed behaviours and seed and fruit types. Comparison of the seed ontogeny and anatomy partly explained the differences in seed behaviour between these two species of Brazilian legumes; some differences were also related to fruit development. The seed coat in C. ferrea consisted of two layers of osteosclereids, as well as macrosclereids and fibres, to form a typical legume seed coat, whereas C. echinata had only macrosclereids and fibres. In C. echinata, the developing seed coat had paracytic stomata, a feature rarely found in legume seeds. These seed coat features may account for the low longevity of C. echinata seeds. The embryogeny was similar in both species, with no differences in the relationship between embryo growth and seed growth. The seeds of both species behaved as typical endospermic seeds, despite their different morphological classification (exendospermic orthodox seeds were described for C. echinata and endospermic orthodox seeds for C. ferrea). Embryo growth in C. ferrea accelerated when the sclerenchyma of the pericarp was developing, whereas embryonic growth in C. echinata was associated with the conclusion of spine and secretory reservoir development in the pericarp. Other features observed included an endothelial layer that secreted mucilage in both species, a nucellar summit, which grew up into the micropyle, and a placental obturator that connected the ovarian tissue to the ovule in C. ferrea. (C) 2004 the Linnean Society of London.

Storage sites in seeds of Caesalpinia echinata and C. ferrea (Leguminosae) with considerations on nutrients flow

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

Morfoanatomia e ontogênese do fruto e semente de Vernonia platensis (Spreng.) Less. (Asteraceae)

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

Energy substrate utilization during nightly vocal activity in three species of Scinax (Anura/Hylidae)

Anuran amphibians exhibit different patterns of energy substrate utilization that correlate with the intensity of vocal and locomotor activities. Given the remarkable differences among species in breeding and feeding strategies, and the different ways energy is used in the whole animal, the suggested correlations between calling and locomotor behavior and the level of energy substrates in the muscles responsible for such activities are more complex than previously reported. We explored the relationships between calling and locomotor behavior and energy supply to trunk and hindlimb muscles, respectively, within the ecologically diverse tree-frog genus Scinax. Specifically, we measured the relative amount of carbohydrates and lipids in these two groups of muscles, and in the liver of three species of Scinax that differ in vocal and locomotor performance, and compared our results with those of two other species for which comparable data are available. We also compared the contents of lipids and carbohydrates of conspecific males collected at the beginning and after 4 h of calling activity. The stomach content to potential feeding opportunities across species was also assessed in both groups of males. Scinax hiemalis and S. rizibilis exhibit comparatively low and episodic calling during long periods of activity whereas S. crospedospilus calls at higher rates over shorter periods. Male S. hiemalis had highest levels of trunk muscle glycogen followed by those of S. rizilbilis and S. crospedospilus, respectively. There was no correlation between total lipid content in trunk muscle and calling rate among different species, suggesting that other metabolic aspects may be responsible for the energetic support for vocal activity. The levels of lipids and carbohydrates in trunk and hindlimb muscles and liver of males collected at the beginning and 4 h into the calling period were similar across species, so the extent of energetic reserves does not appear to constrain vocal or locomotor activity. Finally, we found exceptionally high levels of carbohydrates and lipids in the liver of S. rizibilis, a trait perhaps related to a long and demanding breeding period.

Metabolic changes in Brycon cephalus (Teleostei, Characidae) during post-feeding and fasting

Metabolic changes during the transition from post-feeding to fasting were studied in Brycon cephalus, an omnivorous teleost from the Amazon Basin in Brazil. Body weight and somatic indices (liver and digestive tract), glycogen and glucose content in liver and muscle, as well as plasma glucose, free fatty acids (FFA), insulin and glucagon levels of B. cephalus, were measured at 0, 12, 24, 48, 72, 120, 168 and 336 h after the last feeding. At time 0 h (the moment of food administration, 09.00 h) plasma levels of insulin and glucagon were already high, and relatively high values were maintained until 24 h post-feeding. Glycemia was 6.42 +/- 0.82 mM immediately after food ingestion and 7.53 +/- 1.12 MM at 12 h. Simultaneously, a postprandial replenishment of liver and muscle glycogen reserves was observed. Subsequently, a sharp decrease of plasma insulin occurred, from 7.19 +/- 0.83 ng/ml at 24 h of fasting to 5.27 +/- 0.58 ng/ml at 48 h. This decrease coincided with the drop in liver glucose and liver glycogen, which reached the lowest value at 72 h of fasting (328.56 +/- 192.13 and 70.33 +/- 14.13 mumol/g, respectively). Liver glucose increased after 120 h and reached a peak 168 h post-feeding, which suggests that hepatic gluconeogenesis is occurring. Plasma FFA levels were low after 120 and 168 h and increased again at 336 h of fasting. During the transition from post-feeding to fast condition in B. cephalus, the balance between circulating insulin and glucagon quickly adjust its metabolism to the ingestion or deprivation of food. (C) 2002 Elsevier B.V. All rights reserved.

Reproductive effects in male rats exposed to diuron

Diuron is a ureic herbicide considered to have very low toxicity. The present study evaluated several aspects of reproductive toxicity of diuron in adult male rats. Diuron was diluted in corn oil and administered by oral gavage to groups of 18-20 rats at doses of 0, 125 or 250 mg/kg per day for 30 days; the control group received only the corn oil vehicle. At the end of the treatment period, approximately half the animals from each group were assigned to one of two terminal assessment lines: (1) reproductive organ, liver and kidney weights; measurement of diuron concentrations in liver and kidney; plasma testosterone determinations; evaluation of daily sperm production per testis; sperm number and sperm transit time in the epididymis; or (2) sexual behavior assessment during cohabitation with a receptive female; fertility and pregnancy outcome after natural mating; testicular, epididymal, kidney and liver histopathology; sperm morphology. After 30 days of oral diuron treatment, there were no treatment-related changes in body weights, but dose-related diuron residues were detected in the liver of all treated rats and absolute and relative liver weights were increased in both groups. There were no statistically significant differences between the treated and control groups obtained in plasma testosterone concentrations, or in parameters of daily sperm production, sperm reserves in the epididymis, sperm morphology or measured components of male sexual behavior. on the other hand, the number of fetuses in the litters from diuron-treated rats was slightly smaller than litters from control rats. Therefore, although the results did not indicate that diuron exposure resulted in direct male reproductive toxicity in the rat, they suggest that additional studies should be undertaken to investigate the possible effects on fertility and reproductive performance. (c) 2006 Elsevier B.V. All rights reserved.

Persistent Impairment of Testicular Histology and Sperm Motility in Adult Rats Treated with Cisplatin at Peri-Puberty

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effects of altered epididymal sperm transit time on sperm quality

The epididymal sperm transit time seems to have an important role in the process of sperm maturation, and it seems that alterations to the transit can harm the process. The aim of the present work was to evaluate the influence of altered sperm transit time through the epididymis on sperm parameters and fertility of rats, as well as the role of testosterone in the alterations. Sprague-Dawley adult male rats were randomly assigned to four different groups and were treated for 12 days: (i) 10 mu g/rat/day DES, to accelerate the transit; (ii) 6.25 mg/kg/day guanethidine sulphate, to delay the transit; (iii) same treatment as group 1, plus androgen supplementation; (iv) control animals received the vehicles. Guanethidine treatment delayed the sperm transit time through the epididymal cauda, provoking increased sperm reserves in this region. Animals exposed to DES showed an acceleration of sperm transit time in the epididymis, and consequently decreased sperm density in both epididymal regions, the caput-corpus and cauda, and diminished sperm motility. In both cases sperm production was not altered. Testosterone supplementation was able to restore the transit time to values close to normality, as they were higher than in the control rats. The same occurred in relation to sperm motility. Rats exposed to DES presented lower fertility after in utero artificial insemination using sperm collected from the proximal cauda epididymis. Therefore, it was concluded that the acceleration of rat sperm transit time appeared to harm normal sperm maturation, thus decreasing sperm quality and fertility capacity, in an androgen-dependent way.