Effect of haematocrit on pump and kidney dysfunction after myocardial revascularization

Objective - Kidney dysfunction is a common complication after cardiac surgery. It occurs in 7 to 31% of the patients. The lowest haematocrit after cardiopulmonary bypass surgery (LHCT) has been identified as a risk factor for kidney dysfunction after cardiac surgery. The aim of this study is to determine whether different levels of haematocrit during cardiopulmonary bypass surgery are related to kidney dysfunction.Methods and results-A prospective study was conducted on consecutive adult patients undergoing myocardial revascularization. Preoperative renal function was assessed by baseline serum creatinine level (CrPre). Peak postoperative creatinine (CrPost) was defined as the highest daily in-hospital postoperative value. Peak fractional change in creatinine (% Delta Cr) was defined as the difference between the CrPre and CrePost represented as a percentage of the preoperative value. The LHTC was defined as the lowest recorded haematocrit prior to weaning from the initial pump run. A category variable was created for haematocrit based on the distribution of values. The category variable had the following cut-off points: less than 23%, 23.1 to 28% and greater than 28.1 %. Lowest haematocrit (26.62 +/- 4.15%), CPB (74.71 +/- 24.90 min), CrPre (1.23 +/- 0.37 mg/dl) and highest CrPost (1.52 +/- 0.47 mg/dl) data varied in near-normal fashion. Statistical significance has been observed in the < 23% lowest haematocrit group (CrIPOD and Cr5POD; P = 0.006) and the 23.1 28% lowest haematocrit level group (CrPre and Cr2POD; P = 0.047). CrPre and Cr5POD did not differ between groups (P > 0.05). The multiple linear regression model confirmed that the determinants for higher %Delta Cr were age, body surface area and preoperative serum creatinine level.Conclusion - The LHTC was not identified as a risk factor for kidney dysfunction after myocardial revascularization.

Curvas de percentis de valores normais de medidas ecocardiográficas em crianças eutróficas procedentes da região centro-sul do Estado de São Paulo

OBJETIVO: Avaliar os valores de medidas ecocardiográficas em crianças eutróficas sem cardiopatia, relacionando-os com a superfície corporal (SC, m²), e construir curvas de percentis que relacionem as variáveis ecocardiográficas estudadas com a SC. MÉTODOS: Foram analisadas medidas ecocardiográficas unidimensionais de crianças entre 1 e 144 meses de idade. Avaliaram-se: diâmetros diastólicos dos ventrículos direito (VDd, mm) e esquerdo (VEd, mm), sistólico do VE (VEs, mm), da via de saída do VD (VSVD, mm), da aorta (DAo, mm) e do átrio esquerdo (DAE, mm); fração de ejeção do VE (FEVE, %); porcentagem da variação do diâmetro ventricular esquerdo (deltaVE, %); espessura diastólica do septo interventricular (ESIV, mm) e da parede posterior do VE (EPPVE, mm); massa (MVE, g) e índice de massa muscular do VE (IMVE, g/m²). RESULTADOS: Ao final do estudo, 595 crianças (326 do sexo masculino) foram avaliadas. Os valores das medidas ecocardiográficas apresentaram boa correlação com a SC e possibilitaram a construção de curvas de percentis (3%, 25%, 50%, 75% e 97%). Diferenças estatisticamente significantes, entre os sexos, foram evidenciadas para as variáveis VEs, VEd, VSVD, DAo, MVE e IMVE, sendo os maiores valores observados em crianças do sexo masculino. CONCLUSÃO: As curvas de percentis dos valores obtidas podem ser utilizadas como referência para a avaliação de crianças com suspeita de cardiopatia ou para o acompanhamento daquelas já diagnosticadas como cardiopatas ou em tratamento com agentes potencialmente cardiotóxicos.

Expanded description of Lamproglena monodi (Copepoda: Lernaeidae), parasitizing native and introduced fishes in Brazil

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

Morphological changes in distant muscle fibers following thermal injury in Wistar rats

Purpose: Thermal injury causes catabolic processes as the body attempts to repair the damaged area. This study evaluated the effects of a scald injury on the morphology of muscle fibers belonging to a muscle distant from the lesion. Methods: Thirty Wistar rats were divided into control (C) and scalded (S) groups. Group S was scalded over 45% of the body surface, standardized by body weight. Rats in both groups were euthanized at four, seven and 14 days following the injury. The middle portions of the medial gastrocnemius muscles were sectioned, stained with hematoxylin and eosin and Picrosirius, and submitted to histological analysis. Results: Control group sections exhibited equidistantly distributed polygonal muscle fibers with peripheral nuclei, characteristic of normal muscle. The injured group sections did not consistently show these characteristics; many fibers in these sections exhibited a rounded contour, variable stain intensities, and greater interfiber distances. A substantially increased amount of connective tissue was also observed on the injured group sections. Conclusion: This experimental model found a morphological change in muscle distant from the site of thermal injury covering 45% of the body surface.

Gill infection of Leporinus macrocephalus Garavello & Britski, 1988 (Osteichthyes: Anostomidae) by Henneguya leporinicola n. sp. (Myxozoa: Myxobolidae). Description, histopathology and treatment

Piauçus (Leporinus macrocephalus) criados em viveiro de 300 m² (densidade de 10 peixes/m²) apresentavam sinais de asfixia e mortalidade diária de 27 peixes. Exemplares com 8 cm em média foram examinados quanto à presença de lesões e seus possíveis agentes. Muco da superfície corporal e fragmentos de órgãos foram colhidos e examinados à microscopia de luz, em esfregaços a fresco ou corados ou em cortes histológicos. O exame dos esfregaços mostrou a presença de inúmeros esporos entre as lamelas secundárias dos filamentos branquiais, identificados como Henneguya leporinicola n.sp (Myxozoa: Myxobolidae). À histopatologia verificou-se marcada hiperplasia epitelial com preenchimento dos espaços entre as lamelas secundárias, congestão e teleangiectasia sinusoidal. Observou-se ainda hiperplasia de células caliciformes e inúmeros cistos do parasito, com até 70,3 mim de diâmetro, localizados entre as lamelas secundárias, recobertos ou não pelo epitélio hiperplásico. Estabelecido o diagnóstico foram realizadas três aplicações de formalina na dose de 10 ml/m³ de água. Após 15 dias da última dose do tratamento, os peixes foram novamente examinados, constatando-se a eficácia das medidas adotadas para interromper a mortalidade, a enfermidade e combater o parasitismo. As únicas alterações teciduais presentes nas brânquias nesse último exame foram moderada congestão sinusoidal e discreta hiperplasia epitelial na base das lamelas secundárias.

High volume peritoneal dialysis for acute renal failure

Background. Peritoneal dialysis (PD) is still widely used for acute renal failure (ARF) in developing countries despite concerns about its inadequacy. Continuous PD has been evaluated in ARF by analyzing the resolution of metabolic abnormality and normalization of plasma pH, bicarbonate, and potassium.Methodology: A prospective study was performed on 30 ARF patients who were assigned to high-dose continuous PD (Kt/V = 0.65 per session) via a flexible catheter (Tenckhoff) and automated PD with a cycler. Fluid removal, pH and metabolic control, protein Loss, and patient outcome were evaluated.Results: Patients received 236 continuous PD sessions; 76% were admitted to ICUs. APACHE II score was 32.2 +/- 8.65. BUN concentrations stabilized after 3 sessions, creatinine after 4, and bicarbonate and pH after 2. Fluid removal was 2.1 +/- 0.62 L/day. Creatinine and urea clearances were 15.8 +/- 4.16 and 17.3 +/- 5.01 mL/minute respectively. Normalized creatinine clearance and urea Kt/V values were 110.6 +/- 22.5 L/week/1.73 m(2) body surface area and 3.8 +/- 0.6 respectively. Solute reduction index was 41% +/- 6.5% per session. Serum albumin values remained stable in spite of considerable protein tosses (median 21.7 g/day, interquartile range 9.1 - 29.8 g/day). Regarding ARF outcome, 23% of patients presented renal function recovery, 13% remained on dialysis after 30 days of follow-up, and 57% died.Conclusion: High-dose continuous PD by flexible catheter and cycler was an effective treatment for ARF. It provided high solute removal, allowing appropriate metabolic and pH control, and adequate dialysis dose and fluid removal. Continuous PD can therefore be considered an alternative to other forms of renal replacement therapy in ARF.

Investigation of the systems silica and silica containing chromium in alcohol medium

The purpose of this work is to obtain micrometer sized spherical particles of silica and silica-chromium from sodium silicate. Spherical particles were prepared by sol-gel method from hydrolysis to polycondensation of aqueous sodium silicate in alcohol medium. Chromium was added to the system for some samples. Compositions and morphologies were achieved by changing the precipitation agent. X-ray diffractometry, electrophoretic mobility, infrared spectroscopy and scanning electron microscopies were carried out on these particles to identify phases, determine particle mobility, morphology, particle sizes, shapes and order at short distance. Non-crystalline silica particles with spherical shapes and micrometric size were obtained. The surface potentials of the silica particles differed from that of the silica-chromium particles. (C) 1999 Elsevier B.V. B.V. All rights reserved.

ESTIVATION IN SOUTH-AMERICAN AMPHIBIANS AND REPTILES

A number of amphibians and reptiles have cyclic behavior, becoming inactive with the coming of the dry season. In South America this pattern of activity is common, particularly in savannah-like vegetation. During the dry season amphibians burrow into the mud or soil, and either form a cocoon or increase the osmotic concentration of body fluids to reduce evaporative water loss. Some phyllomedusid tree frogs coat their body surface with skin secretion and excrete uric acid to minimize water loss. Reptiles also retreat into shelter deep enough to avoid temperature fluctuation during estivation or reduce metabolic response to temperature. Reduction of temperature sensitivity of the metabolism seems to be a strategy common to estivating amphibians and reptiles. Despite seasonal change of the environment, some species of reptiles are active all year round.

Dipole moments in Langmuir monolayers from aromatic carboxylic acids

The three-layer capacitor model proposed by Demchak and Fort [J. Colloid Interface Sci. 46 (1974) 191] is employed to relate measured surface potentials of Langmuir monolayers from a series of polyphenyl carboxylic acids to molecular dipole moments calculated using semiempirical quantum methods. The effective dielectric constant at the air/monolayer interface is 3.0 +/- 0.6, very close to that estimated for aliphatic compounds. Good agreement between theory and experiment is obtained by adopting a dielectric constant of 6.4 for the monolayer/water interface and a contribution from the water reorientation of -0.064 +/- 0.006 D, which shows that the parameters in the DF model are essentially the same as for aliphatic amphiphiles, such as esters, acids, alcohols and ethers. (C) 2000 Elsevier B.V. B.V. All rights reserved.

Ventricular systolic reserve in asymptomatic children previously treated with low doses of anthracyclines: A longitudinal, prospective exercise echocardiography study

Background: The time course of mild cardiotoxicity induced by anthracycline remains unknown. The aim of this study was to evaluate the long-term evolution of decreased myocardial reserve in children previously treated with a cumulative dose of anthracycline up to 100mg/m 2. Patients and Methods: Twenty-seven asymptomatic cancer survival patients (25 with lymphoblastic leukemia), in continuous remission and off treatment for >12 months with no alterations in conventional echocardiograms were evaluated by exercise echocardiography at 37±15.4 months (T1) and 101±24 months (T2) after finishing treatment (ADRIA group). This group was compared with 25 healthy individuals (control group) similar to the ADRIA group with respect to age and body surface area (BSA). All individuals underwent treadmill exercise testing according to Bruce protocol. Echocardiograms were performed before and immediately after exercise. Results: The groups were similar regarding cardiac structure and left ventricular (LV) systolic function at rest at T1 and T2. The growth of LV posterior wall thickness related to BSA was lower in the ADRIA group at T2. Post exercise, smaller LV ejection indexes and attenuated changes in the afterload in ADRIA group were observed at T1 and T2. Conclusion: The decreased systolic reserve induced by a low dose of anthracycline in asymptomatic children and adolescents remains unaffected over a 5-year period, suggesting that positive outcomes in chronic cardiotoxicity would be expected in patients with mild impairment after anthracycline treatment. © 2011 Wiley Periodicals, Inc.

Brazilian catfish parasitized by Epistylis sp. (Ciliophora, Epistylididae), with description of parasite intensity score

The determination of mean intensity of parasitism for colony-forming sessile protozoan such as Epistylis has been a great problem in parasitological studies. Some alternatives have been proposed by researchers for laboratory and field conditions. This study describes the criteria to establish the parasitic intensity score for epistylidid infestation in fish. Parasite distribution and the host-parasite relationship in four species of Brazilian cultured catfish and their hybrids are discussed. The highest prevalence rates were found in the hybrid jundiara, Leiarius marmoratus male × Pseudoplatystoma reticulatum female (96.4 %), followed by jurupoca, Hemisorubim platyrhynchos (60 %), and the hybrid surubim, Pseudoplatystoma corruscans male × P. reticulatum female (52.7 %). Positive correlation between parasitic intensity score and the fish size, weight, and relative condition factor were also observed. These findings indicate that Epistylis infestation in Brazilian catfish is an emerging disease in cultured fish. © 2012 Springer-Verlag.

Doppler echocardiography in athletes from different sports

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efeito da tosquia na temperatura corpórea e outros parâmetros clínicos em ovinos

The aim of this study was to determine the variation of the temperature after shearing in sheep under dry and hot environment conditions and to compare the temperature changes with variation in cardiac and respiratory frequencies, ruminal movements and hydration status. Twenty Suffolk unshorn ewes were studied. Physical examination was performed in all animals three times a day at 7:00 AM, 1:00 PM and 7:00 PM, during 42 days (22 days before shearing and 20 days after shearing). The skin temperature was measured by infrared thermometer over several surfaces of the body. Data were submitted to analysis of variance, for comparisons between groups (shorn versus unshorn) at each time, and the significant difference was evaluated at level of P<0.05 by Tukey test. The respiratory frequency was statistically significant at all times. When air humidity was high, the respiratory frequencies were low. The thermal stress was clear in sheep of this study, reflecting marked changes in cardiac and respiratory frequencies and rectal temperature. The respiratory frequency was the parameter more reliable to establish a framework of thermal stress in the unshorn sheep, with values on average three times higher than those reported in the literature. The heart rate monitors the thermal variation of the environment and is also an indicator of heat stress. This variation shows the Suffolk breed is well adapted to hot climates. The correlation between the body surface temperatures with environment temperature and air humidity was negative, as explained by the effect of wool insulation, i.e. even with an increase in environment temperature and humidity, the body temperature tends to maintain a compensating balance. In the shorn animals, the correlation between skin temperature with environment temperature and air humidity showed that the skin temperature increases when the environment temperature increases. The increase in the environment temperature does not affect the body temperature of unshorn animals due the insulating effect of the wool. However, when environment temperature rises, the presence of the wool starts to affect the thermal comfort as the heat absorption is larger than the capacity of heat loss. In this study, the best thermal stress indicators were the respiratory frequency and rectal and skin temperatures. The temperatures of the skin measured at the perineum, axillae and inner thigh were considered the most reliable.

Perfil nutricional e imunológico de índividuos queimados atendidos no Hospital Estadual Bauru no momento da internação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Identificação sorológica e perfil de susceptibilidade a antimicrobianos em amostras de Escherichia coli isoladas de peixe e água de pesque-pagues

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)