Papel do ecocardiograma transesofágico tridimensional na ótima seleção do dispositivo para o tratamento percutâneo da comunicação interatrial tipo ostium secundum

INTRODUCAO: A comunicação interatrial tipo \"ostium secundum\" é um defeito cardíaco congênito caracterizado pela deficiência parcial ou total da lâmina da fossa oval, também chamada de septo primo. Corresponde a 10 a 12% do total de cardiopatias congênitas, sendo a mais frequente na idade adulta. Atualmente a oclusão percutânea é o método terapêutico de escolha em defeitos com características anatômicas favoráveis para o implante de próteses na maioria dos grandes centros mundiais. A ecocardiografia transesofágica bidimensional com mapeamento de fluxo em cores é considerada a ferramenta padrão-ouro para a avaliação anatômica e monitoração durante do procedimento, sendo crucial para a ótima seleção do dispositivo. Neste sentido, um balão medidor é introduzido e insuflado através do defeito de forma a ocluí-lo temporariamente. A medida da cintura que se visualiza no balão (diâmetro estirado) é utilizada como referência para a escolha do tamanho da prótese. Recentemente a ecocardiografia tridimensional transesofágica em tempo real tem sido utilizada neste tipo de intervenção percutânea. Neste estudo avaliamos o papel da mesma na ótima seleção do dispositivo levando-se em consideração as dimensões e a geometria do defeito e a espessura das bordas do septo interatrial. METODO: Estudo observacional, prospectivo, não randomizado, de único braço, de uma coorte de 33 pacientes adultos portadores de comunicação interatrial submetidos a fechamento percutâneo utilizando dispositivo de nitinol autocentrável (Cera ®, Lifetech Scientific, Shenzhen, China). Foram analisadas as medidas do maior e menor diâmetro do defeito, sua área e as medidas do diâmetro estirado com balão medidor obtidas por meio das duas modalidades ecocardiográficas. Os defeitos foram considerados como elípticos ou circulares segundo a sua geometria; as bordas ao redor da comunicação foram consideradas espessas (>2 mm) ou finas. O dispositivo selecionado foi igual ou ate 2 mm maior que o diâmetro estirado na ecocardiografia transesofágica bidimensional (padrão-ouro). Na tentativa de identificar uma variável que pudesse substituir o diâmetro estirado do balão para a ótima escolha do dispositivo uma série de correlações lineares foram realizadas. RESULTADOS: A idade e peso médio foram de 42,1 ± 14,9 anos e 66,0 ± 9,4kg, respectivamente; sendo 22 de sexo feminino. Não houve diferenças estatísticas entre os diâmetros maior e menor ou no diâmetro estirado dos defeitos determinados por ambas as modalidades ecocardiográficas. A correlação entre as medidas obtidas com ambos os métodos foi ótima (r > 0,90). O maior diâmetro do defeito, obtido à ecoardiografia transesofágica tridimensional, foi a variável com melhor correlação com o tamanho do dispositivo selecionado no grupo como um todo (r= 0,89) e, especialmente, nos subgrupos com geometria elíptica (r= 0,96) e com bordas espessas ao redor do defeito (r= 0,96). CONCLUSÃO: Neste estudo em adultos com comunicações interatriais tipo ostium secundum submetidos à oclusão percutânea com a prótese Cera ®, a ótima seleção do dispositivo pôde ser realizada utilizando-se apenas a maior medida do defeito obtida na ecocardiografia transesofágica tridimensional em tempo real, especialmente nos pacientes com defeitos elípticos e com bordas espessas.

New Mediterranean Biodiversity Records (June 2012)

The present work reports on the extended distribution of nineteen species in the Mediterranean. These are: Upeneus pori (Fish:Turkey), Bursatella leachii (Mollusca, Opisthobranchia: eastern coast of Spain), Sparisoma cretense (Fish: Ionian coast of Greece), Pseudobryopsis myura (Chlorophyta:Turkey), Aplysia dactylomela (Mollusca, Opisthobranchia: Karpathos island, and Kyklades Archipelago, Greece), Asparagopsis armata and Botryocladia madagascariensis (Rhodophyta: South Peloponnesos, Greece), Oxynotus centrina (Fish: Greece), Caulerpa racemosa var. cylindracea (Chlorophyta ), Stypopodium schimperi (Phaeophyta ) Siganus luridus and Stephanolepis diaspros (Fish) Percnon gibbesi (Decapoda, Brachyura) (Kyklades Archipelago, Greece), Cerithium scabridum (Mollusca, Prosobranchia: Anavissos: Greece) and Cerithium renovatum (Mollusca, Prosobranchia: N. Κriti), Cassiopea andromeda (Scyphomedusa: Rhodos Island, Greece), Abra tenuis (Mollusca Bivalvia: Vouliagmeni Lake, Greece) Lagocephalus lagocephalus (Fish: Calabrian coast, Italy) and Plocamopherus ocellatus (Mollusca, Opisthobranchia: İskenderun Bay, Turkey).

Cenozoic nannofossils from the Exmouth Plateau, eastern Indian Ocean

Six sites (759-764) were drilled on the Exmouth Plateau during Ocean Drilling Program Leg 122. Nannofossilrich Cenozoic sediments were recovered at all six sites, reflecting the open-ocean conditions that prevailed over the Exmouth Plateau during the Cenozoic. Calcareous nannofossils are abundant, diverse (250 different species identified), and generally well preserved throughout the composite lower Paleocene to Quaternary section. The diversity and preservation of nannofossils permits a high degree of stratigraphic resolution at each site. Site 762 on the central part of the Exmouth Plateau contains an almost unbroken Cenozoic record (only Miocene Zones NN3, NN8, and NN10 are missing). This site may prove to be a useful Cenozoic biostratigraphic and biomagnetochronologic reference section for the eastern Indian Ocean.

Paleontological and sedimentological investigations of a sediment profile from northeast Greenland

The Kap Mackenzie area on the outer coast of northeast Greenland was glaciated during the last glacial stage, and pre-Holocene shell material was brought to the area. Dating of marine shells indicates that deglaciation occurred in the earliest Holocene, before 10 800 cal. a BP. The marine limit is around 53 m a.s.l. In the wake of the deglaciation, a glaciomarine fauna characterized the area, but after c. one millennium a more species-rich marine fauna took over. This fauna included Mytilus edulis and Mysella sovaliki, which do not live in the region at present; the latter is new to the Holocene fauna of northeast Greenland. The oldest M. edulis sample is dated to c. 9500 cal. a BP, which is the earliest date for the species from the region and indicates that the Holocene thermal maximum began earlier in the region than previously documented. This is supported by driftwood dated to c. 9650 cal. a BP, which is the earliest driftwood date so far from northeastern Greenland and implies that the coastal area was at least partly free of sea ice in summer. As indicated by former studies, the Storegga tsunami hit the Kap Mackenzie area at c. 8100 cal. a BP. Loon Lake, at 18 m a.s.l., was isolated from the sea at c. 6200 cal. a BP, which is distinctly later than expected from existing relative sea-level curves for the region.

Abundance of copepods from multinet samples during POLARSTERN cruise ANT-XXII/2 (ISPOL)

The mesozooplankton community, with special emphasis on calanoid copepods, was studied with respect to its species composition, abundance, vertical distribution and developmental structure during the ISPOL expedition to the ice covered western Weddell Sea. Stratified zooplankton tows were carried out nine times between December 1, 2004 and January 2, 2005 with a multiple opening-closing net between 0 and 1000 m depth. Copepods were by far the most abundant taxon contributing more than 94% of the total mesozooplankton. Numerical dominants were cyclopoid copepods, mostly Oncaea spp. A total of 66 calanoid copepod species were identified, but the calanoid copepod community was characterised by the dominance of only a few species. The most numerous species was Microcalanus pygmaeus, which comprised on average 70% of all calanoids. Calanoides acutus and Metridia gerlachei represented other abundant calanoid species contributing an average of 8 and 7%, respectively. All other species comprised less than 3%. The temporal changes in the abundance and population structure of M. pygmaeus and M. gerlachei were small while a shift in the stage frequency distribution of C. acutus was observed during the study: CIV dominated the C. acutus population with 48 to 50% during the first week of December, while CV comprised 48% in late December. CI and CII of C. acutus were absent in the samples and males occurred only in very low numbers in greater depths. In M. gerlachei, CI was not found, whereas all developmental stages of M. pygmaeus occurred throughout the study. All three species showed migratory behaviour, and they occurred in upper water layers towards the end of the investigation. This vertical ascent was most pronounced in C. acutus and relatively weak in the other two species. In M. pygmaeus and M. gerlachei, copepodite stages were responsible for the upward migration in late December, while the vertical distribution of adults did not change. In C. acutus all abundant developmental stages (CIV, CV and females) ascended to upper water layers. Almost exclusively (93%) medium- and semi-ripe females of C. acutus and M. gerlachei were found, and only 3 - 4% of the ovaries were ripe. The absence of CI and the low number of ripe females indicate that the main reproductive period had not started in C. acutus and M. gerlachei until the end of our study in early January. In contrast, the high portion of CI and CII of M. pygmaeus suggests that reproduction of this species had started in October-November and hence, before the onset of the phytoplankton bloom in the water. The community structure did not differ between stations with one exception on December 26, when the station was strongly influenced by the continental shelf.

Diatom abundance in sediments of ODP Holes 186-1150A and 186-1151C

The diatom flora from two sediment cores recovered from the upper 27 meters below seafloor (mbsf) in the oceanic frontal area off Sanriku, northeast Japan, during Ocean Drilling Program Leg 186 were analyzed. Diatom abundance seems to be in interglacial stages and suggests a south-north shifting of the frontal area. Diatom temperature values are less reliable because frequency of the warm-water species is smaller. Site 1151 was in a warm climate at ~50 ka, as were Deep Sea Drilling Project Sites 579 and 580 in the western North Pacific Ocean. A mixed diatom assemblage in the upper 3 mbsf at Site 1150 is evidence that the Tsugaru Warm Current flowed into the studied area through the Tsugaru Strait.