Pollen profile from sediment core Höllerer See

(expanded by Eberhard Grüger, Göttingen) The site "Höllerer See" is a lake in the northern foreland of the Alps, about 30 km north of the city of Salzburg/Austria, situated in the south-western part of Oberösterreich/Austria. A 2 m long piston core from this locality, consisting entirely of calcareous gyttja, was studied by pollen analysis. The three lowermost samples (1.98, 1.95 and 1.92 m) were deposited during the Preboreal when Pinus and Betula were still the dominating forest trees. High pollen values of thermophilous woody species (mainly Corylus and Quercus, but also Ulmus, Tilia, Fraxinus) prove the Boreal age of the next younger sample (1.91 m). The following two pollen spectra attest that Alnus (1.89 m) and - later (1.88 m) - Fagus had become important members of the local (Alnus) and the regional (Fagus) vegetation. From this level up to the top of the profile these two tree taxa contribute - together with Betula - always 50 to 80 % to the arboreal pollen sum. The upper 1.89 m of sediment of the Höllerer See core evidently date from the Subboreal and the Subatlantic. As Preboreal sediment was stated at the base of the profile it must be concluded that most of the Boreal and the Atlantic is - for whatever reason - not represented by sediment in this core. As no radiocarbon dates are available age estimates of the distinguished pollen zones can be achieved only by correlating major changes of the former vegetation with historical events which probably influenced the then contemporary vegetation. The pollen grains of the Triticum and Hordeum type found in samples of zone 2.1 might indicate the growing of cereals in the region during the Late Bronze Age. The first pollen grains of Secale date from the boundary Hallstatt/Latène Age (zone 2.2). The cereal curves become continuous in Bavarian times (Bajuwarenzeit, Middle Ages, zone 3.3). The Plantago laceolata curve, continuous since 1.7 m depth (zone 2.1), points to animal breeding since the Early Subatlantic (Hallstattzeit). This curve reaches its absolute maximum in Roman time (zone 3.1). Roman time forest clearance caused a drastic decrease of tree pollen curves (start of zone 3.1). Values of anthropogenic indicators as high as in zone 3.1 are found again - after a distinct decrease in zone 3.2 - not till the Bavarians settled in the region (6th century). Maximal Fagus values and the simultaneous total lack of anthropogenic indicators mark the Migration Period (zone 3.2). The Younger Subatlantic (zone 4) is characterized by a decrease of deciduous forests due to medieval forest clearance. At the same time the conifers Pinus and Picea gained in importance. The lake was probably used for retting hemp in Medieval times. The distinction of the pollen grains of Cannabis and Humulus might not be certain in all cases. It is known that hemp as well as hop was cultivated in the study area. Markers were added to the samples at the beginning of pollen preparation (13500 Lycopodium spores, sample volume 0.5 cm**3) and counted together with the pollen grains. Therefore pollen concentrations can be calculated: Concentration = C * F / V (with C = number of grains of a particular pollen type, V = volume of the untreated pollen sample, F = marker added/marker counted). F ranges from 39 to 1688. Factors that large are not suited to produce reliably interpretable pollen concentrations. Consequently no use was made of the pollen concentrations in this thesis, although a concentration diagram is added.

Estimate of the total ice volume of Svalbard glaciers and their potential contribution to sea-level rise = Estimación del volumen de hielo de Svalbard y su contribución potencial a la subida del nivel del mar

El objetivo final de las investigaciones recogidas en esta tesis doctoral es la estimación del volumen de hielo total de los ms de 1600 glaciares de Svalbard, en el Ártico, y, con ello, su contribución potencial a la subida del nivel medio del mar en un escenario de calentamiento global. Los cálculos más exactos del volumen de un glaciar se efectúan a partir de medidas del espesor de hielo obtenidas con georradar. Sin embargo, estas medidas no son viables para conjuntos grandes de glaciares, debido al coste, dificultades logísticas y tiempo requerido por ellas, especialmente en las regiones polares o de montaña. Frente a ello, la determinación de áreas de glaciares a partir de imágenes de satélite sí es viable a escalas global y regional, por lo que las relaciones de escala volumen-área constituyen el mecanismo más adecuado para las estimaciones de volúmenes globales y regionales, como las realizadas para Svalbard en esta tesis. Como parte del trabajo de tesis, hemos elaborado un inventario de los glaciares de Svalbard en los que se han efectuado radioecosondeos, y hemos realizado los cálculos del volumen de hielo de más de 80 cuencas glaciares de Svalbard a partir de datos de georradar. Estos volúmenes han sido utilizados para calibrar las relaciones volumen-área desarrolladas en la tesis. Los datos de georradar han sido obtenidos en diversas campañas llevadas a cabo por grupos de investigación internacionales, gran parte de ellas lideradas por el Grupo de Simulación Numérica en Ciencias e Ingeniería de la Universidad Politécnica de Madrid, del que forman parte la doctoranda y los directores de tesis. Además, se ha desarrollado una metodología para la estimación del error en el cálculo de volumen, que aporta una novedosa técnica de cálculo del error de interpolación para conjuntos de datos del tipo de los obtenidos con perfiles de georradar, que presentan distribuciones espaciales con unos patrones muy característicos pero con una densidad de datos muy irregular. Hemos obtenido en este trabajo de tesis relaciones de escala específicas para los glaciares de Svalbard, explorando la sensibilidad de los parámetros a diferentes morfologías glaciares, e incorporando nuevas variables. En particular, hemos efectuado experimentos orientados a verificar si las relaciones de escala obtenidas caracterizando los glaciares individuales por su tamaño, pendiente o forma implican diferencias significativas en el volumen total estimado para los glaciares de Svalbard, y si esta partición implica algún patrón significativo en los parámetros de las relaciones de escala. Nuestros resultados indican que, para un valor constante del factor multiplicativo de la relacin de escala, el exponente que afecta al área en la relación volumen-área decrece según aumentan la pendiente y el factor de forma, mientras que las clasificaciones basadas en tamaño no muestran un patrón significativo. Esto significa que los glaciares con mayores pendientes y de tipo circo son menos sensibles a los cambios de área. Además, los volúmenes de la población total de los glaciares de Svalbard calculados con fraccionamiento en grupos por tamaño y pendiente son un 1-4% menores que los obtenidas usando la totalidad de glaciares sin fraccionamiento en grupos, mientras que los volúmenes calculados fraccionando por forma son un 3-5% mayores. También realizamos experimentos multivariable para obtener estimaciones óptimas del volumen total mediante una combinación de distintos predictores. Nuestros resultados muestran que un modelo potencial simple volumen-área explica el 98.6% de la varianza. Sólo el predictor longitud del glaciar proporciona significación estadística cuando se usa además del área del glaciar, aunque el coeficiente de determinación disminuye en comparación con el modelo más simple V-A. El predictor intervalo de altitud no proporciona información adicional cuando se usa además del área del glaciar. Nuestras estimaciones del volumen de la totalidad de glaciares de Svalbard usando las diferentes relaciones de escala obtenidas en esta tesis oscilan entre 6890 y 8106 km3, con errores relativos del orden de 6.6-8.1%. El valor medio de nuestras estimaciones, que puede ser considerado como nuestra mejor estimación del volumen, es de 7.504 km3. En términos de equivalente en nivel del mar (SLE), nuestras estimaciones corresponden a una subida potencial del nivel del mar de 17-20 mm SLE, promediando 19_2 mm SLE, donde el error corresponde al error en volumen antes indicado. En comparación, las estimaciones usando las relaciones V-A de otros autores son de 13-26 mm SLE, promediando 20 _ 2 mm SLE, donde el error representa la desviación estándar de las distintas estimaciones. ABSTRACT The final aim of the research involved in this doctoral thesis is the estimation of the total ice volume of the more than 1600 glaciers of Svalbard, in the Arctic region, and thus their potential contribution to sea-level rise under a global warming scenario. The most accurate calculations of glacier volumes are those based on ice-thicknesses measured by groundpenetrating radar (GPR). However, such measurements are not viable for very large sets of glaciers, due to their cost, logistic difficulties and time requirements, especially in polar or mountain regions. On the contrary, the calculation of glacier areas from satellite images is perfectly viable at global and regional scales, so the volume-area scaling relationships are the most useful tool to determine glacier volumes at global and regional scales, as done for Svalbard in this PhD thesis. As part of the PhD work, we have compiled an inventory of the radio-echo sounded glaciers in Svalbard, and we have performed the volume calculations for more than 80 glacier basins in Svalbard from GPR data. These volumes have been used to calibrate the volume-area relationships derived in this dissertation. Such GPR data have been obtained during fieldwork campaigns carried out by international teams, often lead by the Group of Numerical Simulation in Science and Engineering of the Technical University of Madrid, to which the PhD candidate and her supervisors belong. Furthermore, we have developed a methodology to estimate the error in the volume calculation, which includes a novel technique to calculate the interpolation error for data sets of the type produced by GPR profiling, which show very characteristic data distribution patterns but with very irregular data density. We have derived in this dissertation scaling relationships specific for Svalbard glaciers, exploring the sensitivity of the scaling parameters to different glacier morphologies and adding new variables. In particular, we did experiments aimed to verify whether scaling relationships obtained through characterization of individual glacier shape, slope and size imply significant differences in the estimated volume of the total population of Svalbard glaciers, and whether this partitioning implies any noticeable pattern in the scaling relationship parameters. Our results indicate that, for a fixed value of the factor in the scaling relationship, the exponent of the area in the volume-area relationship decreases as slope and shape increase, whereas size-based classifications do not reveal any clear trend. This means that steep slopes and cirque-type glaciers are less sensitive to changes in glacier area. Moreover, the volumes of the total population of Svalbard glaciers calculated according to partitioning in subgroups by size and slope are smaller (by 1-4%) than that obtained considering all glaciers without partitioning into subgroups, whereas the volumes calculated according to partitioning in subgroups by shape are 3-5% larger. We also did multivariate experiments attempting to optimally predict the volume of Svalbard glaciers from a combination of different predictors. Our results show that a simple power-type V-A model explains 98.6% of the variance. Only the predictor glacier length provides statistical significance when used in addition to the predictor glacier area, though the coefficient of determination decreases as compared with the simpler V-A model. The predictor elevation range did not provide any additional information when used in addition to glacier area. Our estimates of the volume of the entire population of Svalbard glaciers using the different scaling relationships that we have derived along this thesis range within 6890-8106 km3, with estimated relative errors in total volume of the order of 6.6-8.1% The average value of all of our estimates, which could be used as a best estimate for the volume, is 7,504 km3. In terms of sea-level equivalent (SLE), our volume estimates correspond to a potential contribution to sea-level rise within 17-20 mm SLE, averaging 19 _ 2 mm SLE, where the quoted error corresponds to our estimated relative error in volume. For comparison, the estimates using the V-A scaling relations found in the literature range within 13-26 mm SLE, averaging 20 _ 2 mm SLE, where the quoted error represents the standard deviation of the different estimates.

Sildenafil na hipertensão pulmonar persistente do recém-nascido associada a hérnia diafragmática congénita

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Essays and essay-writing, based on Atlantic monthly models,

"Made up almost entirely of short, familiar essays published anonymously in the 'Contributors' club' of the Atlantic."--Pref.

Study of hexane adsorption in nanoporous MCM-41 silica

We study here the adsorption of hexane on nanoporous MCM-41 silica at 303, 313, and 323 K, for various pore diameters between 2.40 and 4.24 nm. Adsorption equilibria, measured thermogravimetrically, show that all the isotherms, that are somewhat akin to those of type V, exhibit remarkably sharp capillary adsorption phase transition steps and are reversible. The position of the phase transition step gradually shifts from low to high relative pressure with an increase in the temperature as well as the pore sizes. The isosteric heats of adsorption derived from the equilibrium information using the Clapeyron equation reveal a gradual decrease with increasing adsorbed amount because of the surface heterogeneity but approach a constant value near the phase transition. A decrease in the pore size results in an increase in the isosteric heat of adsorption because of the increased dispersion forces. A simple strategy, based on the Broekhoff and De Boer adsorption theory, successfully interprets the hexane adsorption isotherms for the different pore size MCM-41 samples. The parameters of an empirical expression, used to represent the potential of interaction between the adsorbate and adsorbent, are obtained by fitting the monolayer region prior to capillary condensation and the experimental phase transition simultaneously, for some pore sizes. Subsequently, the parameters are used to predict the adsorption isotherm on other pore size samples, which showed good agreement with experimental data.

Comparison of clinical trials with sildenafil, vardenafil and tadalafil in erectile dysfunction

Erectile dysfunction (ED) affects up to 50% of men, between 40 and 70 years of age. In the first major trial of sildenafil in ED, at 24 weeks, improved erections were reported by 77 and 84% of men taking sildenafil 50 and 100 mg, respectively. Subsequently, sildenafil has been reported to be effective in men with ED associated with diabetes and prostate cancer, and in psychogenic ED. Sildenafil is safe in men with coronary artery disease, provided it is not used with the nitrates (a contraindication). The most commonly reported adverse effects with sildenafil are headache, flushing and dyspepsia. Vardenafil is more potent and more selective than sildenafil at inhibiting phosphodiesterase-5. Vardenafil is similarly effective to sildenafil in the treatment of ED. The only advantage that vardenafil has over sildenafil is that it does not inhibit phosphodiesterase-6 to alter colour perception, a rare side effect which sometimes occurs with sildenafil. Tadalafil has a longer duration of action than sildenafil and vardenafil. Tadalafil is similarly effective as sildenafil in the treatment of ED. In comparison studies, tadalafil is preferred to sildenafil (50/100 mg) by men with ED, possibly because of its longer duration of action. of the phosphodiesterase inhibitors, tadalafil may displace sildenafil as the drug of choice among men with ED.

Differential gene expression in the developing mouse ureter

In many instances, kidney dysgenesis results as a secondary consequence to defects in the development of the ureter. Through the use of mouse genetics a number of genes associated with such malformations have been identified, however, the cause of many other abnormalities remain unknown. In order to identify novel genes involved in ureter development we compared gene expression in embryonic day (E) 12.5, E15.5 and postnatal day (P) 75 ureters using the Compugen mouse long oligo microarrays. A total of 248 genes were dynamically upregulated and 208 downregulated between E12.5 and P75. At E12.5, when the mouse ureter is comprised of a simple cuboidal epithelium surrounded by ureteric mesenchyme, genes previously reported to be expressed in the ureteric mesenchyme, foxC1 and foxC2 were upregulated. By E15.5 the epithelial layer develops into urothelium, impermeable to urine, and smooth muscle develops for the peristaltic movement of urine towards the bladder. The development of these two cell types coincided with the upregulation of UPIIIa, RAB27b and PPAR gamma reported to be expressed in the urothelium, and several muscle genes, Acta1, Tnnt2, Myocd, and Tpm2. In situ hybridization identified several novel genes with spatial expression within the smooth muscle, Acta1; ureteric mesenchyme and smooth muscle, Thbs2 and Co15a2; and urothelium, Kcnj8 and Adh1. This study marks the first known report defining global gene expression of the developing mouse ureter and will provide insight into the molecular mechanisms underlying kidney and lower urinary tract malformations. (c) 2005 Elsevier B.V. All rights reserved.

Safety and tolerability considerations in the use of sildenafil for children with pulmonary arterial hypertension.

Sildenafil is a phosphodiesterase type-5 inhibitor approved for treatment of pulmonary arterial hypertension (PAH) in adults. Data from pediatric trials demonstrate a similar acute safety profile to the adult population but have raised concerns regarding the safety of long-term use in children. Interpretation of these trials remains controversial with major regulatory agencies differing in their recommendations - the US Food and Drug Administration recommends against the use of sildenafil for treatment of PAH in children, while the European Medicines Agency supports its use at "low doses". Here, we review the available pediatric data regarding dosing, acute, and long-term safety and efficacy of sildenafil for the treatment of PAH in children.

Elemental composition of various manganese nodules

Manganese nodules have been observed over wide areas of both the Pacific and Atlantic Oceans, however, deposits in the Pacific Ocean are generally much richer in elements of economic interest such as nickel, copper and cobalt. In understanding the genesis and the geochemistry involved in their formation and growth, it is important to know the total chemical composition of these nodules and how they vary within a given deposit and between deposits in the oceans of the world. The concentrations of elements: nickel, copper, cobalt, iron, manganese, silicon, and calcium, in all of the manganese nodules which have been analyzed were recently summarized by Horn et al. (1972). These observations indicate certain correlations, both positive and negative, between Mn and the associated elements within the nodules. Their data suggest similarities in chemical composition for nodules from a given area; however, the analyses of Mn nodules, like that of the ocean water, itself, has large errors associated with some of the measurements. This is understandable, since many of these measurements were intended to provide an approximate indication of elemental content. Where one is interested in carefully preparing a description of Mn nodule chemical composition which can serve as a basis for formulating theories regarding their genesis and subsequent geochemical changes in the ocean environment, then very precise and accurate analyses are essential. The purpose of this study has been to measure the concentrations of 18 elements in Mn nodules with a high degree of accuracy and determine what correlations exist between element concentrations. The scope of this study was seriously limited and therefore was confined to one area of the Pacific Ocean at approximately 22 N latitude, 114 W longitude, at an ocean depth of approximately 11,000 feet.

Quitosana imobilizada em suporte inerte para a adsorção de corantes alimentícios em coluna de leito fixo

O uso de corantes sintéticos na indústria de alimentos tem provocado transtornos à saúde humana e ao meio ambiente. A quitosana pode ser imobilizada em matrizes sólidas e aplicada na remoção de corantes em coluna de leito fixo. A análise da dinâmica de uma coluna de leito fixo é baseada na curva de ruptura, esta é dependente da geometria da coluna, das condições operacionais e dos dados de equilíbrio. Neste contexto, o objetivo deste trabalho foi estudar o recobrimento de esferas de vidro por quitosana e sua aplicação como adsorvente de corantes em coluna de leito fixo. No estudo do recobrimento avaliaram-se os efeitos da concentração de quitosana e dos métodos de cura. As esferas recobertas foram aplicadas em ensaios de adsorção estático e dinâmico. Inicialmente, avaliou-se o equilíbrio de adsorção através da construção de isotermas e ajuste de modelos, e após, avaliaram-se os efeitos do tipo de cura e do grau de desacetilação da quitosana. Em seguida, foram analisados os efeitos do tipo de corante e do pH, e o comportamento cinético da adsorção pela construção de curvas de ruptura e ajuste de modelos dinâmicos. A influência da altura do leito e da concentração inicial de corante sobre os parâmetros da adsorção em leito fixo foram analisados através da metodologia de superfície de resposta (MSR). Ao final, estudou-se a regeneração da coluna. Os resultados mostraram que os maiores percentuais de recobrimento foram obtidos pelos métodos físico e físico/químico, na concentração de quitosana de 0,5% (m/v). Nestas condições o percentual de recobrimento foi de 46%. Nas imagens da superfície das esferas (MEV) observou-se que as mesmas foram recobertas de forma homogênea pela quitosana. As isotermas de equilíbrio obtidas foram classificadas como do tipo V, sendo o modelo de Sips o mais adequado para representar os dados experimentais. As capacidades máximas de adsorção foram 337 mg g-1, 286 mg g-1 e 200 mg g-1 para os corantes amarelo tartrazina, amarelo crepúsculo e vermelho 40, respectivamente. A aplicação das esferas recobertas com quitosana em leito fixo mostrou-se mais adequada utilizando o método de cura físico/químico e quitosana com grau de desacetilação de 85%. A máxima capacidade de adsorção da coluna em função do corante e do pH variou de 13 a 108 mg g–1. Os modelos BDST (bed–depth–service–time), Thomas e Yoon–Nelson foram adequados para representar os dados experimentais. De acordo com a MSR, o melhor desempenho do leito foi com altura de 30 cm e concentração inicial de corante de 50 mg L-1. Nestas condições, obteve-se tempo de ruptura de 88 min, máxima capacidade da coluna de 108 mg g-1 e remoção de 86 %. Na regeneração da coluna observou-se que cerca de 75% da capacidade máxima da coluna foi mantida após cinco ciclos de adsorção–eluição. Diante do exposto, a coluna de leito fixo empacotada com esferas recobertas com quitosana mostrou-se promissora na remoção de corantes de soluções aquosas.

Bloqueio meiótico como alternativa para aumentar a produção de embriões clone por transferência nuclear

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Agronomia e Medicina Veterinária, 2016.

A Livestock-Associated, Multidrug-Resistant, Methicillin-Resistant Staphylococcus aureus Clonal Complex 97 Lineage Spreading in Dairy Cattle and Pigs in Italy

Pandemic methicillin-resistant Staphylococcus aureus (MRSA) clonal complex 97 (CC97) lineages originated from livestock-to-human host jumps. In recent years, CC97 has become one of the major MRSA lineages detected in Italian farmed animals. The aim of this study was to characterize and analyze differences in MRSA and methicillin-susceptible S. aureus (MSSA) mainly of swine and bovine origins. Forty-seven CC97 isolates, 35 MRSA isolates, and 6 MSSA isolates from different Italian pig and cattle holdings; 5 pig MRSA isolates from Germany; and 1 human MSSA isolate from Spain were characterized by macrorestriction pulsed-field gel electrophoresis (PFGE) analysis, multilocus sequence typing (MLST), spa typing, staphylococcal cassette chromosome mec (SCCmec) typing, and antimicrobial resistance pattern analysis. Virulence and resistance genes were investigated by PCR and microarray analysis. Most of the isolates were of SCCmec type V (SCCmec V), except for two German MRSA isolates (SCCmec III). Five main clusters were identified by PFGE, with the German isolates (clusters I and II) showing 60.5% similarity with the Italian isolates, most of which (68.1%) grouped into cluster V. All CC97 isolates were Panton-Valentine leukocidin (PVL) negative, and a few (n = 7) tested positive for sak or scn. All MRSA isolates were multidrug resistant (MDR), and the main features were erm(B)- or erm(C)-mediated (n = 18) macrolide-lincosamide-streptogramin B resistance, vga(A)-mediated (n = 37) pleuromutilin resistance, fluoroquinolone resistance (n = 33), tet(K) in 32/37 tet(M)-positive isolates, and blaZ in almost all MRSA isolates. Few host-associated differences were detected among CC97 MRSA isolates: their extensive MDR nature in both pigs and dairy cattle may be a consequence of a spillback from pigs of a MRSA lineage that originated in cattle as MSSA and needs further investigation. Measures should be implemented at the farm level to prevent spillover to humans in intensive farming areas.

Effects Of Pde Type 5 Inhibitors On Left Ventricular Diastolic Dysfunction In Resistant Hypertension.

Resistant hypertension (RHTN) is a multifactorial disease characterized by blood pressure (BP) levels above goal (140/90 mmHg) in spite of the concurrent use of three or more antihypertensive drugs of different classes. Moreover, it is well known that RHTN subjects have high prevalence of left ventricular diastolic dysfunction (LVDD), which leads to increased risk of heart failure progression. This review gathers data from studies evaluating the effects of phosphodiesterase-5 (PDE-5) inhibitors (administration of acute sildenafil and short-term tadalafil) on diastolic function, biochemical and hemodynamic parameters in patients with RHTN. Acute study with sildenafil treatment found that inhibition of PDE-5 improved hemodynamic parameters and diastolic relaxation. In addition, short-term study with the use of tadalafil demonstrated improvement of LVDD, cGMP and BNP-32 levels, regardless of BP reduction. No endothelial function changes were observed in the studies. The findings of acute and short-term studies revealed potential therapeutic effects of IPDE-5 drugs on LVDD in RHTN patients.A Hipertensão arterial resistente (HAR) é uma doença multifatorial caracterizada por níveis pressóricos acima das metas (140/90 mmHg), a despeito de tratamento farmacológico otimizado de 3 ou mais fármacos anti-hipertensivos de diferentes classes. Pacientes diagnosticados como hipertensos resistentes apresentam alta prevalência de disfunção diastólica do ventrículo esquerdo (DDVE) que proporciona risco aumentado para insuficiência cardíaca. Esta revisão reúne dados de estudos prévios avaliando os efeitos dos inibidores de fosfodiesterase-5 (PDE-5) (administração aguda de sildenafil e de curto prazo de tadalafil) na função diastólica e nos parâmetros bioquímicos e hemodinâmicos em pacientes com HAR. O estudo agudo com sildenafil demonstrou que a inibição da PDE-5 melhorou os parâmetros hemodinâmicos e de relaxamento diastólico. Além disso, o estudo curto prazo com o uso de tadalafil revelou melhora da DDVE e dos níveis de GMPc e BNP-32, independente de redução de pressão arterial. A função endotelial não apresentou alteração com ambos os tratamentos. Os resultados dos estudos agudo e de curto prazo sugerem efeitos terapêuticos potenciais dos fármacos inibidores da PDE-5 na disfunção diastólica em pacientes com HAR.

Effects of PDE type 5 inhibitors on Left Ventricular Diastolic Dysfunction in Resistant Hypertension

Resistant hypertension (RHTN) is a multifactorial disease characterized by blood pressure (BP) levels above goal (140/90 mmHg) in spite of the concurrent use of three or more antihypertensive drugs of different classes. Moreover, it is well known that RHTN subjects have high prevalence of left ventricular diastolic dysfunction (LVDD), which leads to increased risk of heart failure progression. This review gathers data from studies evaluating the effects of phosphodiesterase-5 (PDE-5) inhibitors (administration of acute sildenafil and short-term tadalafil) on diastolic function, biochemical and hemodynamic parameters in patients with RHTN. Acute study with sildenafil treatment found that inhibition of PDE-5 improved hemodynamic parameters and diastolic relaxation. In addition, short-term study with the use of tadalafil demonstrated improvement of LVDD, cGMP and BNP-32 levels, regardless of BP reduction. No endothelial function changes were observed in the studies. The findings of acute and short-term studies revealed potential therapeutic effects of IPDE-5 drugs on LVDD in RHTN patients.

Phosphodiesterase-5 inhibition mimics intermittent reoxygenation and improves cardioprotection in the hypoxic myocardium.

Although chronic hypoxia is a claimed myocardial risk factor reducing tolerance to ischemia/reperfusion (I/R), intermittent reoxygenation has beneficial effects and enhances heart tolerance to I/R. AIM OF THE STUDY: To test the hypothesis that, by mimicking intermittent reoxygenation, selective inhibition of phosphodiesterase-5 activity improves ischemia tolerance during hypoxia. Adult male Sprague-Dawley rats were exposed to hypoxia for 15 days (10% O₂) and treated with placebo, sildenafil (1.4 mg/kg/day, i. p.), intermittent reoxygenation (1 h/day exposure to room air) or both. Controls were normoxic hearts. To assess tolerance to I/R all hearts were subjected to 30-min regional ischemia by left anterior descending coronary artery ligation followed by 3 h-reperfusion. Whereas hypoxia depressed tolerance to I/R, both sildenafil and intermittent reoxygenation reduced the infarct size without exhibiting cumulative effects. The changes in myocardial cGMP, apoptosis (DNA fragmentation), caspase-3 activity (alternative marker for cardiomyocyte apoptosis), eNOS phosphorylation and Akt activity paralleled the changes in cardioprotection. However, the level of plasma nitrates and nitrites was higher in the sildenafil+intermittent reoxygenation than sildenafil and intermittent reoxygenation groups, whereas total eNOS and Akt proteins were unchanged throughout. CONCLUSIONS: Sildenafil administration has the potential to mimic the cardioprotective effects led by intermittent reoxygenation, thereby opening the possibility to treat patients unable to be reoxygenated through a pharmacological modulation of NO-dependent mechanisms.