Left Atrial Function in Patients with Chronic Chagasic Cardiomyopathy

Background:Chagas disease is a cause of dilated cardiomyopathy, and information about left atrial (LA) function in this disease still lacks.Objective:To assess the different LA functions (reservoir, conduit and pump functions) and their correlation with the echocardiographic parameters of left ventricular (LV) systolic and diastolic functions.Methods:10 control subjects (CG), and patients with Chagas disease as follows: 26 with the indeterminate form (GI); 30 with ECG alterations (GII); and 19 with LV dysfunction (GIII). All patients underwent M-mode and two-dimensional echocardiography, pulsed-wave Doppler and tissue Doppler imaging.Results:Reservoir function (Total Emptying Fraction: TEF): (p <0.0001), lower in GIII as compared to CG (p = 0.003), GI (p <0.001) and GII (p <0.001). Conduit function (Passive Emptying Fraction: PEF): (p = 0.004), lower in GIII (GIII and CG, p = 0.06; GI and GII, p = 0.06; and GII and GIII, p = 0.07). Pump function (Active Emptying Fraction: AEF): (p = 0.0001), lower in GIII as compared to CG (p = 0.05), GI (p<0.0001) and GII (p = 0.002). There was a negative correlation of E/e’average with the reservoir and pump functions (TEF and AEF), and a positive correlation of e’average with s’ wave (both septal and lateral walls) and the reservoir, conduit and pump LA functions.Conclusion:An impairment of LA functions in Chagas cardiomyopathy was observed.

Metabolic Syndrome and Importance of Associated Variables in Children and Adolescents in Guabiruba - SC, Brazil

Background:The risk factors that characterize metabolic syndrome (MetS) may be present in childhood and adolescence, increasing the risk of cardiovascular disease in adulthood.Objective:Evaluate the prevalence of MetS and the importance of its associated variables, including insulin resistance (IR), in children and adolescents in the city of Guabiruba-SC, Brazil.Methods:Cross-sectional study with 1011 students (6–14 years, 52.4% girls, 58.5% children). Blood samples were collected for measurement of biochemical parameters by routine laboratory methods. IR was estimated by the HOMA-IR index, and weight, height, waist circumference and blood pressure were determined. Multivariate logistic regression models were used to examine the associations between risk variables and MetS.Results:The prevalence of MetS, IR, overweight and obesity in the cohort were 14%, 8.5%, 21% and 13%, respectively. Among students with MetS, 27% had IR, 33% were overweight, 45.5% were obese and 22% were eutrophic. IR was more common in overweight (48%) and obese (41%) students when compared with eutrophic individuals (11%; p = 0.034). The variables with greatest influence on the development of MetS were obesity (OR = 32.7), overweight (OR = 6.1), IR (OR = 4.4; p ≤ 0.0001 for all) and age (OR = 1.15; p = 0.014).Conclusion:There was a high prevalence of MetS in children and adolescents evaluated in this study. Students who were obese, overweight or insulin resistant had higher chances of developing the syndrome.

p.Q192R SNP of PON1 seems not to be Associated with Carotid Atherosclerosis Risk Factors in an Asymptomatic and Normolipidemic Brazilian Population Sample

Background:Evidences suggest that paraoxonase 1 (PON1) confers important antioxidant and anti-inflammatory properties when associated with high-density lipoprotein (HDL).Objective:To investigate the relationships between p.Q192R SNP ofPON1, biochemical parameters and carotid atherosclerosis in an asymptomatic, normolipidemic Brazilian population sample.Methods:We studied 584 volunteers (females n = 326, males n = 258; 19-75 years of age). Total genomic DNA was extracted and SNP was detected in the TaqMan® SNP OpenArray® genotyping platform (Applied Biosystems, Foster City, CA). Plasma lipoproteins and apolipoproteins were determined and PON1 activity was measured using paraoxon as a substrate. High-resolution β-mode ultrasonography was used to measure cIMT and the presence of carotid atherosclerotic plaques in a subgroup of individuals (n = 317).Results:The presence of p.192Q was associated with a significant increase in PON1 activity (RR = 12.30 (11.38); RQ = 46.96 (22.35); QQ = 85.35 (24.83) μmol/min; p < 0.0001), HDL-C (RR= 45 (37); RQ = 62 (39); QQ = 69 (29) mg/dL; p < 0.001) and apo A-I (RR = 140.76 ± 36.39; RQ = 147.62 ± 36.92; QQ = 147.49 ± 36.65 mg/dL; p = 0.019). Stepwise regression analysis revealed that heterozygous and p.192Q carriers influenced by 58% PON1 activity towards paraoxon. The univariate linear regression analysis demonstrated that p.Q192R SNP was not associated with mean cIMT; as a result, in the multiple regression analysis, no variables were selected with 5% significance. In logistic regression analysis, the studied parameters were not associated with the presence of carotid plaques.Conclusion:In low-risk individuals, the presence of the p.192Q variant ofPON1 is associated with a beneficial plasma lipid profile but not with carotid atherosclerosis.

Cardiac Surgery Costs According to the Preoperative Risk in the Brazilian Public Health System

AbstractBackground:Heart surgery has developed with increasing patient complexity.Objective:To assess the use of resources and real costs stratified by risk factors of patients submitted to surgical cardiac procedures and to compare them with the values reimbursed by the Brazilian Unified Health System (SUS).Method:All cardiac surgery procedures performed between January and July 2013 in a tertiary referral center were analyzed. Demographic and clinical data allowed the calculation of the value reimbursed by the Brazilian SUS. Patients were stratified as low, intermediate and high-risk categories according to the EuroSCORE. Clinical outcomes, use of resources and costs (real costs versus SUS) were compared between established risk groups.Results:Postoperative mortality rates of low, intermediate and high-risk EuroSCORE risk strata showed a significant linear positive correlation (EuroSCORE: 3.8%, 10%, and 25%; p < 0.0001), as well as occurrence of any postoperative complication EuroSCORE: 13.7%, 20.7%, and 30.8%, respectively; p = 0.006). Accordingly, length-of-stay increased from 20.9 days to 24.8 and 29.2 days (p < 0.001). The real cost was parallel to increased resource use according to EuroSCORE risk strata (R$ 27.116,00 ± R$ 13.928,00 versus R$ 34.854,00 ± R$ 27.814,00 versus R$ 43.234,00 ± R$ 26.009,00, respectively; p < 0.001). SUS reimbursement also increased (R$ 14.306,00 ± R$ 4.571,00 versus R$ 16.217,00 ± R$ 7.298,00 versus R$ 19.548,00 ± R$935,00; p < 0.001). However, as the EuroSCORE increased, there was significant difference (p < 0.0001) between the real cost increasing slope and the SUS reimbursement elevation per EuroSCORE risk strata.Conclusion:Higher EuroSCORE was related to higher postoperative mortality, complications, length of stay, and costs. Although SUS reimbursement increased according to risk, it was not proportional to real costs.

Alternatives to Aerobic Exercise Prescription in Patients with Chronic Heart Failure

Background: Exercise is essential for patients with heart failure as it leads to a reduction in morbidity and mortality as well as improved functional capacity and oxygen uptake (v̇O2). However, the need for an experienced physiologist and the cost of the exam may render the cardiopulmonary exercise test (CPET) unfeasible. Thus, the six-minute walk test (6MWT) and step test (ST) may be alternatives for exercise prescription. Objective: The aim was to correlate heart rate (HR) during the 6MWT and ST with HR at the anaerobic threshold (HRAT) and peak HR (HRP) obtained on the CPET. Methods: Eighty-three patients (58 ± 11 years) with heart failure (NYHA class II) were included and all subjects had optimized medication for at least 3 months. Evaluations involved CPET (v̇O2, HRAT, HRP), 6MWT (HR6MWT) and ST (HRST). Results: The participants exhibited severe ventricular dysfunction (ejection fraction: 31 ± 7%) and low peak v̇O2 (15.2 ± 3.1 mL.kg-1.min-1). HRP (113 ± 19 bpm) was higher than HRAT (92 ± 14 bpm; p < 0.05) and HR6MWT (94 ± 13 bpm; p < 0.05). No significant difference was found between HRP and HRST. Moreover, a strong correlation was found between HRAT and HR6MWT (r = 0.81; p < 0.0001), and between HRP and HRST (r = 0.89; p < 0.0001). Conclusion: These findings suggest that, in the absence of CPET, exercise prescription can be performed by use of 6MWT and ST, based on HR6MWT and HRST

Very Long-Term Prognostic Role of Admission BNP in Non-ST Segment Elevation Acute Coronary Syndrome

Abstract Background: BNP has been extensively evaluated to determine short- and intermediate-term prognosis in patients with acute coronary syndrome, but its role in long-term mortality is not known. Objective: To determine the very long-term prognostic role of B-type natriuretic peptide (BNP) for all-cause mortality in patients with non-ST segment elevation acute coronary syndrome (NSTEACS). Methods: A cohort of 224 consecutive patients with NSTEACS, prospectively seen in the Emergency Department, had BNP measured on arrival to establish prognosis, and underwent a median 9.34-year follow-up for all-cause mortality. Results: Unstable angina was diagnosed in 52.2%, and non-ST segment elevation myocardial infarction, in 47.8%. Median admission BNP was 81.9 pg/mL (IQ range = 22.2; 225) and mortality rate was correlated with increasing BNP quartiles: 14.3; 16.1; 48.2; and 73.2% (p < 0.0001). ROC curve disclosed 100 pg/mL as the best BNP cut-off value for mortality prediction (area under the curve = 0.789, 95% CI= 0.723-0.854), being a strong predictor of late mortality: BNP < 100 = 17.3% vs. BNP ≥ 100 = 65.0%, RR = 3.76 (95% CI = 2.49-5.63, p < 0.001). On logistic regression analysis, age >72 years (OR = 3.79, 95% CI = 1.62-8.86, p = 0.002), BNP ≥ 100 pg/mL (OR = 6.24, 95% CI = 2.95-13.23, p < 0.001) and estimated glomerular filtration rate (OR = 0.98, 95% CI = 0.97-0.99, p = 0.049) were independent late-mortality predictors. Conclusions: BNP measured at hospital admission in patients with NSTEACS is a strong, independent predictor of very long-term all-cause mortality. This study allows raising the hypothesis that BNP should be measured in all patients with NSTEACS at the index event for long-term risk stratification.

Aerobic Training after Myocardial Infarction: Remodeling Evaluated by Cardiac Magnetic Resonance

Abstract Background: Numerous studies show the benefits of exercise training after myocardial infarction (MI). Nevertheless, the effects on function and remodeling are still controversial. Objectives: To evaluate, in patients after (MI), the effects of aerobic exercise of moderate intensity on ventricular remodeling by cardiac magnetic resonance imaging (CMR). Methods: 26 male patients, 52.9 ± 7.9 years, after a first MI, were assigned to groups: trained group (TG), 18; and control group (CG), 8. The TG performed supervised aerobic exercise on treadmill twice a week, and unsupervised sessions on 2 additional days per week, for at least 3 months. Laboratory tests, anthropometric measurements, resting heart rate (HR), exercise test, and CMR were conducted at baseline and follow-up. Results: The TG showed a 10.8% reduction in fasting blood glucose (p = 0.01), and a 7.3-bpm reduction in resting HR in both sitting and supine positions (p < 0.0001). There was an increase in oxygen uptake only in the TG (35.4 ± 8.1 to 49.1 ± 9.6 mL/kg/min, p < 0.0001). There was a statistically significant decrease in the TG left ventricular mass (LVmass) (128.7 ± 38.9 to 117.2 ± 27.2 g, p = 0.0032). There were no statistically significant changes in the values of left ventricular end-diastolic volume (LVEDV) and ejection fraction in the groups. The LVmass/EDV ratio demonstrated a statistically significant positive remodeling in the TG (p = 0.015). Conclusions: Aerobic exercise of moderate intensity improved physical capacity and other cardiovascular variables. A positive remodeling was identified in the TG, where a left ventricular diastolic dimension increase was associated with LVmass reduction.

Solos incorporados de vinhaça e seu teor de bases

A presente pesquisa foi realizada visando esclarecer dúvidas surgidas quando da determinação dos valores "T" (capacidade total do solo para bases de dupla troca), "S" (bases suscetíveis de dupla troca) e "H" (hidrogênio suscetível de dupla troca) de solos que receberam altas doses de vinhaça Tais valores, quando determinados pelo processo recomendado por A O. A. C. (2), desviam-se dos normais passando "S" (parte) a ser maior do que "T" (todo). Diversas porções de um mesmo solo depois de convenientemente preparadas foram tratadas em vasos de ferro zincado com doses crescentes de vinhaça como segue: Primeiro grupo (vasos 1, 2, 3 e 4): testemunhas; Sgundo grupo (vasos 5, 6, 7 e 8): incorporação de vinhaça em volume equivalente a 250.0001 por hectare; Terceiro grupo (vasos 9, 10, 11 e 12): idem ao anterior aumentando as dos»\s para 500.0001; Quarto grupo (vasos 13, 14, 15 e 16): idem com 750.0001; Quinto grupo (vasos 17, 18, 19 e 20): idem com 1.000.0001. Efetuada a incorporação e depois de sêcos ossolos à sombra, dos mesmos foram retiradas amostras (4 para cada tipo) para as respectivas análises. Estas compreenderam determinações de "T", "S" e "H" por diversos processos, baseados em lixiviação com acetato de amônio neutro e normal, com cloreto de amônio normal e cloreto de bário normal. Foram, ainda, efetuadas determinações para verificação de sais solúveis. Também foram verificados os índices pH e a possibilidade de volatilização de amoníaco durante os processos de lavagem dos solos com álcool concentrado para a retirada de excesso de reativo. Os resultados obtidos foram estudados estatisticamente revelando principalmente que a incorporação de vinhaça ao solo determina neste um aumento de seus valores "T", "S" e índice pH, e diminuição de "H". Revelaram ainda que nos solos tratados com altas doses de vinhaça o valor "T" não deve ser determinado com processos ligados a amônio-saturação (cloreto), uma vez que êste radical peptizando e solubilizando a matéria orgânica do solo faz com que se consigam valores aquém dos reais. Esta interferência é tão grande que pode conduzir ao absurdo de se ter "S" maior do que "T". Os catiônios bivalentes como cálcio e bário, apesar dos inconvenientes que apresentam, são os recomendados para êste caso.

Efeito de lisina no hábito de cristalização do cloreto de cobre

Estuda-se o hábito de cristalização do cloreto de cobre a partir da evaporação de soluções aquosas contendo lisina. São pesquisadas, com 3 repetições cada uma, 30 concentrações diferentes de lisina e cloreto de cobre, sendo 6 de lisina (0,0005, 0,0001, 0,005, 0,01, 0,05 e 0,1 g por placa) combinadas a 5 do sal (0,125, 0,25, 0,5, 0,75 e 1,0 g por placa). Conclui-se que o modelo de cristalização é característico e pode ser reconhecido em extratos em que o efeito cristalogenético do aminoácido seja dominante. As melhores concentrações são as que combinam 0,25 a 0,50 g por placa de cloreto de cobre com 0,005 a 0,1 g por placa de lisina.

Nutrição mineral de Andropogon gayanus Kunth var. bisquamulatus (Hochst) Hack. III. nível critico de fósforo

0 capim gambá (Andropogon gayanus Kunthe var. bisquamulatus) é uma espécie promissora para a pecuária brasileira. 0 presente trabalho foi conduzido no sentido de se determinar o nível crítico de fósforo. Em casa de vegetação, procedeu-se à semeadura em vasos contendo quartzo finalmente moído como substrato. As plântulas recebiam por percolação soluções nutritivas carentes em fósforo, acrescidas dos seguintes níveis de fósforo em mg/l: 0,0001; 0,001; 0,007; 0,030; 0,120; 0,480; 1,940; 7,750 e 31,80. Com a idade de 75 dias, as plantas foram coletadas, secas e analisadas para fósforo total. O nível crítico de fósforo correspondente à produção máxima de matéria seca aos 75 dias foi de 0,022%,e o nível externo foi de 0,480 mg de fósforo por litro de solução nutritiva.

Suscetibilidade de operárias e larvas de abelhas sociais em relação à ricinina

Muitas substâncias de origem vegetal podem ser tóxicas ou apresentar potencial inseticida. Com o objetivo de diminuir a problemática da poluição ambiental alguns estudos vêm tentando substituir os inseticidas artificiais pelos inseticidas botânicos. Ricinus communis (Euphorbiaceae) apresenta uma grande variedade de substâncias sendo a ricinina o principal componente tóxico. Considerando que as abelhas são insetos benéficos por atuarem como agentes polinizadores das plantas, este estudo teve por objetivo avaliar o efeito tóxico da ricinina para as operárias e larvas de Apis mellifera (Linnaeus, 1758) (Hymenoptera, Apidae) e Scaptotrigona postica (Latreille, 1907) (Hymenoptera, Meliponini). Para isso, foram realizados testes de ingestão em operárias confinadas recebendo ricinina incorporada à dieta e testes de aplicação tópica com a substância solubilizada em metanol e aplicada no pronoto das abelhas com auxílio de uma microseringa. Para as larvas foram realizados testes de ingestão e calculada sua taxa de mortalidade. Os resultados mostram atividade tóxica significativa (p < 0.0001) da ricinina nas abelhas adultas das duas espécies para a concentração 0,1% nos testes de ingestão e 0,2% nos testes de aplicação tópica. Outrossim, uma elevada porcentagem de larvas foi afetada negativamente pela ricinina logo nos primeiros dias de vida para todas as concentrações testadas (0,25%, 0,5% e 1%).

Fish assemblages in two sandy beaches in lower Purus river, Amazonas, Brazil

Fish assemblages from two sandy beaches in the lower Purus river (Amazonas, Brazil) were compared. Four sampling groups were represented by: day and night samples in sandy beach inside the Reserva Biológica de Abufari (biological reserve) and day and night samples in the Reserva de Desenvolvimento Sustentável Piagaçu-Purus (sustainable development reserve). Samples were collected during low water levels (November) in 2007. The fish were sampled by means of seines with mesh size of 5 mm between opposing knots, 11 m long and 6 m wide. A total of 112 fish species belonging to nine orders and 27 families was captured. The vast majority of the dominant forms consisted of small fishes (< 100 mm SL) or juveniles. Samples collected in Abufari at night presented more specimens (3,540), higher richness (84 spp.), larger total biomass (76,614 g) and higher diversity (H'= 2.57) than the other groups. The composition of fish assemblages was significantly different among all analyzed groups (ANOSIM, p < 0.0001, R= 0.71). NMDS analysis also clustered all species in four distinct groups according to species composition per period and site. SIMPER analyses showed that 80% of variation of species composition among the groups examined was due to 12 species. However, fish composition did not show any correlation with the abiotic factors examined. Different levels of use in both reserves may explain differences in fish composition.

Comparación ontogénica de la frecuencia de muda en Rhinella marina (Anura, Bufonidae)

La muda es un proceso de renovación de la capa externa de la epidermis (estrato corneo) de los anfibios, la cual suministra protección contra daños, patógenos y pérdida de agua. Este trabajo evalúa la frecuencia de muda entre juveniles y adultos de Rhinella marina (Linnaeus, 1758) y la tasa de ocurrencia entre el día y la noche. Para esto, se realizaron dos observaciones diarias (7 am y 7 pm), entre Octubre de 2011 y Marzo de 2012, a tres grupos de individuos clasificados según su tamaño longitud rostro-cloaca, como adultos (promedio=80 mm), juveniles medianos (promedio=19 mm) y juveniles pequeños (promedio=13 mm). Estos animales fueron colocados en terrarios en el laboratorio y marcados en el dorso a través de un punto hecho con un corrector de tinta. La muda se determinó por la pérdida total de la marca y una coloración brillante en el dorso. Se encontró una diferencia significativa (Kruskal-Wallis, H=19.84, p<0.0001) en el periodo de muda entre los tres grupos de estudio: adultos=7.5 días, juveniles medianos=5.4 días, juveniles pequeños=5.3 días. También, en la frecuencia de animales que mudaron en el día y la noche (Ji-cuadrado, χ2=7.891, p=0.019), particularmente en los dos grupos de juveniles, quienes lo hicieron en la noche, ya que en los adultos no hubo una diferencia clara. Posiblemente, la mayor frecuencia de la muda en los juveniles puede relacionarse con su condición ontogénica, de un menor tamaño corporal, alta tasa metabólica y mayor tasa de desarrollo.

Compared nymphal development of Tingis americana (Hemiptera, Tingidae) in two Handroanthus species (Bignoniaceae) and reproductive parameters in seedlings of Handroanthus heptaphyllus

Nymphs and adults of Tingis americana Drake, 1922 were found feeding on leaves of Handroanthus heptaphyllus (Vell.) Mattos and Handroanthus chrysotrichus (Mart. ex A. DC.) Mattos in the Botanic Garden, Porto Alegre, state of Rio Grande do Sul, Brazil. This is the first record of T. americana on these host plants and in the southern Brazil. We aimed to compare the nymphal development on both hosts and to analyze the reproductive parameters on H. heptaphyllus (25 ± 1ºC; 60 ± 10% RH; 16 h photophase). The mean nymphal period (days) was shorter in individuals reared on H. heptaphyllus (12.69 ± 0.076) than on H. chrysotrichus (19.11 ± 0.208) (P < 0.0001), however, nymph viability was similar. On H. heptaphyllus, the mean embryonic period lasted 12.32 ± 0.274 days and the egg viability was 92%. The mean total and daily fecundity were 310.0 ± 19.40 eggs/female and 7.46 ± 0.302 eggs/female/day, respectively. Paired males and females showed similar longevity (P = 0.0691), while unpaired females lived longer than unpaired males (P = 0.0460).

Variação sazonal no recrutamento de Phragmatopoma caudata (Polychaeta, Sabellariidae) na costa sudeste do Brasil: biometria e validação de metodologia para categorização de classes etárias

Este estudo explora a maturação de gametas e biometria de Phragmatopoma caudata Krøyer in Mörch, 1863 para endossar uma metodologia e oferecer uma técnica adequada para estudos que objetivam avaliar a ecologia populacional. A análise de correlação de Pearson confirmou a relação positiva (r = 0,90, P <0,0001) entre o comprimento do corpo e o comprimento da coroa opercular. Indivíduos com opercular crown < 0,9 mm podem ser considerados como juvenil devido à ausência de gametas. Portanto, utilizando-se o método aprovado para separar as classes de tamanho, a população dos recifes de P. caudata no Parque Estadual Xixová-Japuí (PEJX) na Baía de Santos, Estado de São Paulo, foi examinada durante dois anos, com o objetivo de analisar a densidade populacional e o padrão sazonal da classe juvenil. Em período de elevadas taxas de juvenis, a densidade populacional atingiu 128.115 ind./m², porém, a média foi 65.090±22.033 ind./m². As análises estatísticas (Kruskal-Wallis H = 18,475, p < 0,01) revelaram existir variação significativa na composição juvenil entre as estações chuvosa e seca. Apesar da presença de juvenis em meses de seca, as estações chuvosas contemplaram 92,1% dos juvenis amostrados. O padrão de juvenis observado pode estar relacionado com fatores biológicos (e.g. gametogênese e ciclo de vida) e abióticos (e.g. suprimento alimentar e correntes marinhas). Estes resultados destacam a necessidade de programas de monitoramento de longo prazo que integrem elementos ecológicos e abióticos, a fim de obter uma compreensão mais completa da ecologia desse poliqueta e ajudar a gerenciar a biodiversidade marinha do PEJX.