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.

Cardiovascular Autonomic Dysfunction in Patients with Morbid Obesity

Abstract Background: Morbid obesity is directly related to deterioration in cardiorespiratory capacity, including changes in cardiovascular autonomic modulation. Objective: This study aimed to assess the cardiovascular autonomic function in morbidly obese individuals. Methods: Cross-sectional study, including two groups of participants: Group I, composed by 50 morbidly obese subjects, and Group II, composed by 30 nonobese subjects. The autonomic function was assessed by heart rate variability in the time domain (standard deviation of all normal RR intervals [SDNN]; standard deviation of the normal R-R intervals [SDNN]; square root of the mean squared differences of successive R-R intervals [RMSSD]; and the percentage of interval differences of successive R-R intervals greater than 50 milliseconds [pNN50] than the adjacent interval), and in the frequency domain (high frequency [HF]; low frequency [LF]: integration of power spectral density function in high frequency and low frequency ranges respectively). Between-group comparisons were performed by the Student’s t-test, with a level of significance of 5%. Results: Obese subjects had lower values of SDNN (40.0 ± 18.0 ms vs. 70.0 ± 27.8 ms; p = 0.0004), RMSSD (23.7 ± 13.0 ms vs. 40.3 ± 22.4 ms; p = 0.0030), pNN50 (14.8 ± 10.4 % vs. 25.9 ± 7.2%; p = 0.0061) and HF (30.0 ± 17.5 Hz vs. 51.7 ± 25.5 Hz; p = 0.0023) than controls. Mean LF/HF ratio was higher in Group I (5.0 ± 2.8 vs. 1.0 ± 0.9; p = 0.0189), indicating changes in the sympathovagal balance. No statistical difference in LF was observed between Group I and Group II (50.1 ± 30.2 Hz vs. 40.9 ± 23.9 Hz; p = 0.9013). Conclusion: morbidly obese individuals have increased sympathetic activity and reduced parasympathetic activity, featuring cardiovascular autonomic dysfunction.

Prevalence of Risk for Obstructive Sleep Apnea Syndrome and Association With Risk Factors in Primary Care

Abstract Background: Obstructive sleep apnea syndrome (OSAS) is a chronic, progressive disease with high morbidity and mortality. It is underdiagnosed, especially among women. Objective: To study the prevalence of high risk for OSAS globally and for the Berlin Questionnaire (BQ) categories, and to evaluate the reliability of the BQ use in the population studied. Methods: Observational, cross-sectional study with individuals from the Niterói Family Doctor Program, randomly selected, aged between 45 and 99 years. The visits occurred between August/2011 and December/2012. Variables associated with each BQ category and with high risk for OSAS (global) were included in logistic regression models (p < 0.05). Results: Of the total (616), 403 individuals (65.4%) reported snoring. The prevalence of high risk for OSA was 42.4%, being 49.7% for category I, 10.2% for category II and 77.6% for category III. Conclusion: BQ showed an acceptable reliability after excluding the questions Has anyone noticed that you stop breathing during your sleep? and Have you ever dozed off or fallen asleep while driving?. This should be tested in further studies with samples mostly comprised of women and low educational level individuals. Given the burden of OSAS-related diseases and risks, studies should be conducted to validate new tools and to adapt BQ to better screen OSAS.

Colchicine to Reduce Atrial Fibrillation in the Postoperative Period of Myocardial Revascularization

Abstract Background: The high prevalence of atrial fibrillation (AF) in the postoperative period of myocardial revascularization surgery increases morbidity and mortality. Objective: To assess the efficacy of colchicine to prevent AF in the postoperative period of myocardial revascularization surgery, the impact of AF on hospital length of stay and death, and to identify its risk factors. Methods: Between May 2012 and November 2013, 140 patients submitted to myocardial revascularization surgery were randomized, 69 to the control group and 71 to the colchicine group. Colchicine was used at the dose of 1 mg orally, twice daily, preoperatively, and of 0.5 mg, twice daily, until hospital discharge. A single dose of 1 mg was administered to those admitted 12 hours or less before surgery. Results: The primary endpoint was AF rate in the postoperative period of myocardial revascularization surgery. Colchicine group patients showed no reduction in AF incidence as compared to control group patients (7.04% versus 13.04%, respectively; p = 0.271). There was no statistically significant difference between the groups regarding death from any cause rate (5.6% versus 10.1%; p = 0,363) and hospital length of stay (14.5 ± 11.5 versus 13.3 ± 9.4 days; p = 0.490). However, colchicine group patients had a higher infection rate (26.8% versus 8.7%; p = 0.007). Conclusion: The use of colchicine to prevent AF after myocardial revascularization surgery was not effective in the present study. Brazilian Registry of Clinical Trials number RBR-556dhr.

Wertigkeit der hochauflösenden transabdominellen Sonographie in der Diagnostik der Choledocholithiasis in Abhängigkeit von der Untersuchererfahrung : eine prospektive Studie mit der endoskopischen retrograden Cholangiographie als Goldstandard

Magdeburg, Univ., Medizin. Fak., Diss., 2007

Comportamento de forrageamento e dieta de Polystictus superciliaris (Aves, Tyrannidae) no sudeste do Brasil

O presente artigo descreve o comportamento de forrageamento e a dieta de Polystictus superciliaris (Wied, 1831), espécie pouco conhecida e de distribuição geográfica restrita às montanhas do leste do Brasil. Este trabalho foi realizado entre abril e dezembro de 2005 no Parque Estadual da Serra do Rola Moça, município de Nova Lima, Minas Gerais (20°03'S, 44°00'W). Para cada observação de forrageamento foram registrados os comportamentos de ataque, a direção e o substrato do ataque, a altura do substrato de forrageamento e a fitofisionomia onde o ataque ocorreu. Para a determinação da dieta da espécie foram feitas observações diretas de campo, sendo também analisado o conteúdo estomacal de 16 indivíduos. Polystictus superciliaris usa preferencialmente a canga couraçada (93,3%), tendo como substrato principal as folhas (69,1%) das plantas mais abundantes na área. A espécie é generalista quanto ao comportamento de ataque. A análise de conteúdos estomacais revelou a presença exclusiva de artrópodes. As observações confirmaram o caráter insetívoro de P. superciliaris, que não foi observado consumindo frutos ou outro material de origem vegetal.

A new species of Melanophryniscus (Anura, Bufonidae) from Uruguay

A new species of bufonid toad of the genus Melanophryniscus from northern Uruguay is described. It is included in the M. moreirae group and its external morphology is similar to Melanophryniscus sanmartini. Melanophryniscus sp. nov. is distinguished by having a light brown dorsal coloration with six darker longitudinal glandular ridges on the dorsal surface of the body and the gular region uniformly black.

Advertisement call and female sexual cycle in Uruguayan populations of Physalaemus henselii (Anura, Leiuperidae)

Physalaemus henselii (Peters, 1872) is a little known leiuperid frog that has not been studied since the 1960’s. Herein, we redescribe its advertisement call, and assess the female sexual cycle and the reproductive period on the basis of the macroscopic analysis of the ovaries and field observations. The Ovarian Size Factor (OSF) was calculated. The study was made in Departamento de Rivera, northern Uruguay. The advertisement call consists of short (177 ± 21ms), multipulsed (20 ± 3 pulses/note) notes, with a note repetition rate of 1.57 ± 0.13 notes/s. Physalaemus henselii has a female sexual cycle with unimodal distribution of gravid females, which are present from February to September. The OSF and the ratio "females with mature oocytes / females without mature oocytes" reached the highest values from April to June. The number and size of oocytes were positively correlated with female size. The smallest female (SVL =18.94mm, weight =0.78g) with mature oocytes was found in July. The observed sexual cycle with a single annual reproductive period during the cold season (autumn and early winter), is an uncommon fact for anuran species in the region.

Ecology and natural history of Akodon lindberghi (Rodentia, Sigmodontinae) in southeastern Brazil

We studied the ecology and natural history of the globally threatened and poorly known Akodon lindberghi Hershkovitz, 1990 in Parque Nacional da Serra da Canastra (PNSC) and Juiz de Fora (JF), southeastern Brazil. From November 1998 to September 2001 a total of 131 individuals were captured in wire-cage live-traps and 52 by pitfalls traps. They were all marked and released at the site. The largest abundances were registered during the dry season, and most of the captures occurred in open habitats. The mean body mass of the two populations was significantly different (18.1 g at PNSC versus 13.1 g at JF; H = 46.2678, g.l.=2, p<0.001). In PNSC, individuals were reproductively active from August to February, and juveniles were present from May to August. The results suggest that the changes in vegetation structure caused by deforestation and intensive agricultural activities could increase the predation rate, affecting the mean body mass of the population.

Conservation status assessment of the amphibians and reptiles of Uruguay

The native species of amphibians and reptiles of Uruguay were categorized according to the IUCN Red List criteria. Out of 47 amphibian species, seven are listed as Critically Endangered (CR), five as Endangered (EN), one as Vulnerable (VU), three as Near Threatened (NT), and two as Data Deficient (DD); the remaining species are considered to be Least Concern (LC). Among the 64 species of reptiles evaluated, one is listed as Critically Endangered (CR), seven as Endangered (EN), two as Vulnerable (VU), one as Near Threatened (NT) and seven as Data Deficient (DD); the rest are considered to be Least Concern (LC). The use of these results as an additional criterion in the definition of protected areas in Uruguay will contribute towards the conservation of the aforementioned threatened species and their associated ecosystems.

Variação morfométrica em Bothropoides jararaca (Serpentes, Viperidae) no Rio Grande do Sul

Apesar de machos e fêmeas de serpentes nascerem com o mesmo tamanho, as taxas de crescimento e a idade da maturação sexual podem ser diferentes, determinando dimorfismo sexual em estágios posteriores da vida. Avaliamos a ocorrência de variação morfométrica sexual e ontogenética em Bothropoides jararaca (Wied, 1824), explorando as relações entre tamanho corporal e amadurecimento sexual através de 14 variáveis morfométricas. Foram analisados 142 espécimes provenientes do estado do Rio Grande do Sul, sul do Brasil. Os dados morfométricos - comprimento da cabeça, rostro-cloacal, da cauda, comprimento total; largura da cabeça, ocular, nasal, loreal, da cauda; distância ocular-nasal, ocular-loreal, loreal-nasal, ventral-sinfisal e rostral-labial - e comprimento/diâmetro dos folículos ovarianos, foram tomados em milímetros, através de régua simples e paquímetro analógico de precisão 0,05 mm. A determinação sexual foi realizada por inspeção das gônadas. A classificação etária foi associada à maturidade sexual. Para as análises estatísticas foram utilizadas análises de variância (ANOVA) com teste de Tukey post hoc, regressão linear e análise discriminante canônica (ADC). A maioria das medidas indicou dimorfismo sexual (ANOVA, P<0,05) apenas em adultos (Tukey, P<0,05). As análises de regressão mostram que o comprimento rostro-cloacal explica o comportamento das demais variáveis (P<0,001) e que em todas as medidas as fêmeas crescem mais que os machos. A ADC foi exitosa em separar as classes sexuais e etárias, apresentando significado biológico, considerando 79,2% dos casos como corretamente classificados.

Grupo Drosophila asiri (Diptera, Drosophilidae), un nuevo grupo de especies andinas con la descripción de dos nuevas especies y la redescripción de Drosophila asiri

El nuevo grupo Drosophila asiri pertenece al subgénero Drosophila. Los ejemplares fueron capturados en los bosques andinos del Ecuador, desde los 3200 hasta los 4000 m de altitud. A este grupo pertenecen Drosophila (D.) asiri Vela & Rafael, 2005 previamente ubicada dentro del grupo D. onychophora, y dos nuevas especies; Drosophila (D.) yuragyacum sp. nov. y Drosophila (D.) yanaurcus sp. nov. Las capturas se realizaron en el bosque protector Pasochoa, en la quebrada de Cruz Loma y en el páramo de Papallacta, utilizando cebo de banano y levadura. Los miembros del nuevo grupo por el momento son endémicos de los Andes ecuatorianos. Las tres especies del grupo D. asiri son moscas de tamaño grande (aproximadamente 6 mm). Los machos presentan el edeago quitinizado con dos proyecciones laterales en la cabeza a manera de cuernos muy quitinizados. Estas características diferencian a las especies del grupo D. asiri de otros grupos dentro de Drosophila.

Cuatro especies nuevas del grupo de especies Drosophila mesophragmatica (Diptera, Drosophilidae) de los Andes ecuatorianos

Se describen cuatro especies nuevas del grupo Drosophila mesophragmatica. Las nuevas especies fueron descubiertas en los páramos y remanentes de bosque andino de los Andes ecuatorianos. Las capturas fueron realizadas desde los 2200 hasta los 4000 m de altitud. Las especies nuevas son: D. cashapamba sp. nov., D. chorlavi sp. nov., D. rucux sp. nov. y D. yanayuyu sp. nov. Con las cuatro especies nuevas descubiertas, el número de especies dentro del grupo D. mesophragmatica se incrementa a 17. Los miembros del grupo están distribuidos principalmente en los Andes sudamericanos.

Cuatro nuevas especies del grupo Drosophila onychophora (Diptera, Drosophilidae) en el Parque Arqueológico Rumipamba, Pichincha, Ecuador

Las especies de los subgéneros Phloridosa y Drosophila (este último en relación con los grupos de especies: D. flavopilosa, D. onychophora y D. bromeliae) son especies de Drosophila que se desarrollan únicamente en flores. El grupo D. onychophora fue propuestopara agrupar a especies exclusivamente antófilas. El grupo D. onychophora está integrado por 18 especies, que se encuentran relacionadas con las flores de Asteraceae. En el Parque Arqueológico Rumipamba, provincia de Pichincha, Ecuador, se realizaron capturas de Drosophila, en los meses de febrero, mayo, julio, septiembre y diciembre del 2009. Las especies fueron recolectadas directamente en las flores con un aspirador entomológico. En total se capturaron 427 individuos de Drosophila y se identificaron 11 especies, de las cuales seis son nuevas especies del grupo D. onychophora y una es un nuevo registro para el Ecuador. En este trabajo se describen cuatro de las seis especies nuevas.