RESUMO
Many rural areas of Latin America and the Caribbean (LAC) region are economically depressed. Rural sewage treatment in most areas of LAC is deficient or non-existent. Consequently, the possibility of generating economic revenue from treated sewage is an attractive option for deprived areas of developing countries. Given its peculiar characteristics, rural sewage may be coupled with biological systems such as algae for nutrient cycling. Acceptable algae growth and nutrient elimination were obtained from rural sewage whose treatment may have fallen short of current disposal standards. In this study, aerobic systems working on an 8-month cycle at three different volumetric loading rates (Bv) were assessed in relation to the lifetime growth of three algae strains native to Ecuador. Results indicate Chlorella sp. M2 as the optimal algal strain, with the highest growth rate at Bv of 1 g COD L-1 d- 1 and a removal of organic-N (30%), PO4 3--P (87%) and NH4 +-N (95%). Concomitantly, the kinetic constants of the sewage resulted in a low biomass yield coefficient, making the proposed system highly suitable for developing countries. Finally, the proposed partial recovery stream method, combining nutrient recovery with economic resource generation, appears to contain great potential.
Assuntos
Chlorella , Esgotos , Biomassa , Reatores Biológicos , Equador , Nitrogênio , Eliminação de Resíduos LíquidosRESUMO
The effect of natural antioxidants on physicochemical properties, lipid and protein oxidation, volatile compounds and free fatty acids (FFA) were determined in Spanish salchichón enriched with n-3 fatty acids encapsulated and stabilized in konjac matrix. Phenolic compounds of beer residue extract (BRE), chestnut leaves extract (CLE) and peanut skin extract (PSE) were also identified and quantified. Five batches of salchichón were prepared: control (CON, without antioxidants), butylated hydroxytoluene (BHT), BRE, CLE and PSE. The main phenolic compounds were catechin and benzoic acid for BRE, gallic acid and catechin for CLE and catechin and protocatechuic acid for PSE. Statistical analysis did not show significant differences on chemical composition among treatments. Reductions in luminosity (P<0.05) and pH (P<0.001) were observed with the CLE batch, whereas the other colour parameters were not affected by the addition of natural antioxidants. Finally, the inclusion of antioxidants (P<0.001) decreased the hexanal content, whereas the FFA content increased by the addition of natural extracts.
Assuntos
Antioxidantes/análise , Ácidos Graxos Ômega-3/análise , Mananas/análise , Produtos da Carne/análise , Arachis/química , Hidroxitolueno Butilado/análise , Fenômenos Químicos , Ácidos Graxos não Esterificados/análise , Estudos de Viabilidade , Aditivos Alimentares/análise , Manipulação de Alimentos , Qualidade dos Alimentos , Humanos , Concentração de Íons de Hidrogênio , Hidroxibenzoatos/análise , Nozes/química , Fenóis/análise , Extratos Vegetais/análise , Compostos Orgânicos VoláteisRESUMO
The study examined the radioprotective activity of an aqueous extract from Pleurotus ostreatus mycelium administered to Balb/c mice. Male mice were whole-body irradiated on day 0 ((60)Co, at 0.43 Gy/min) and divided into two groups. The extract was administered intraperitoneally to one group (100 mg/kg) on days - 10 to - 6 and - 2 to +1 with respect to the irradiation. The irradiated-control group was injected with saline solution; non-irradiated mice were used as negative controls. The radioprotective effect was evident by increases in bone marrow cellularity (5.1 × 10(6)/femur vs. 1.1 × 10(6)/femur in saline-control mice, p < 0.05), leucocyte counts (10.5 × 10(9)/L vs. 4.5 × 10(9)/L, p < 0.05), and spleen cellularity (11.2 × 10(7)/spleen vs. 6.2 × 10(7)/spleen, p < 0.05). The extract stimulated macrophage phagocytic activity as judged by a faster rate of carbon clearance in terms of absorbance ratios (1.62 vs. 2.01, p < 0.05). Therefore, this extract may be a candidate therapeutic agent with radioprotective activity for haematopoiesis damage, particularly to cells involved in immune function.
Assuntos
Hematopoese/efeitos dos fármacos , Pleurotus/química , Protetores contra Radiação/química , Agaricales/química , Animais , Medula Óssea/efeitos dos fármacos , Medula Óssea/efeitos da radiação , Contagem de Leucócitos , Macrófagos/efeitos dos fármacos , Masculino , Camundongos Endogâmicos BALB C , Micélio/química , Fagocitose , Baço/efeitos dos fármacos , Baço/efeitos da radiaçãoRESUMO
In this work, an immunohistochemical study was performed to determine the distribution and relative frequencies of some neuromodulators of the digestive tract of silver catfish (Rhamdia quelen). The digestive tract of silver catfish was divided into six portions; the oesophagus, stomach, intestine (ascendant, descendant and convoluted segments), and rectum. Immunohistochemical method using a pool of specific antisera against-gastrin, -cholecystokinin-8, -leu-enkephalin, -neuropeptide Y, -calcitonin gene-related peptide (CGRP), and -vasoactive intestinal peptide (VIP) was employed. Immunoreactivity to all antisera was identified in neuroendocrine cells (NECs) localized in the gut epithelium, although no reaction was observed in the oesophagus or stomach. The morphology of NECs immunopositive to each antibody was similar. They were slender in shape, with basally located nucleus, and their main axis perpendicular to the basement membrane. The number of NECs immunoreactive to all antisera was higher in the ascendant and descendant intestine, exhibiting a decreasing trend toward distal segments of the gut. In addition, immunoreactivity to CGRP and VIP was observed in the myenteric plexus and nerve fibers distributed in the mucosal, submucosal and muscular layers. The higher number of immunopositive NECs in the ascendant and descendant intestine may indicate the primary role of these segments in the control of food intake by means of orexigenic and anorexigenic peripheral signals.
Assuntos
Peixes-Gato/crescimento & desenvolvimento , Peixes-Gato/fisiologia , Trato Gastrointestinal/inervação , Trato Gastrointestinal/metabolismo , Sistemas Neurossecretores/citologia , Sistemas Neurossecretores/metabolismo , Animais , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Contagem de Células , Colecistocinina/metabolismo , Encefalina Leucina/metabolismo , Sistema Nervoso Entérico/citologia , Sistema Nervoso Entérico/metabolismo , Feminino , Gastrinas/metabolismo , Trato Gastrointestinal/citologia , Soros Imunes , Imuno-Histoquímica , Masculino , Neuropeptídeo Y/metabolismo , Fragmentos de Peptídeos/metabolismoRESUMO
An external pinkish growing mass that emerged from the right nostril of an adult goldfish Carassius auratus L. was evaluated by means of light microscopy and immunohistochemistry. The neoplasm presented a well-developed fibrovascular stroma associated with solid cell nests and a large number of Flexner-Wintersteiner rosettes. Myelinated fibres were observed around them. Neoplastic cells showed a prominent degree of nuclear atypia and low mitotic activity. The latter was in agreement with the low reactivity of tumour cells to anti-proliferating cell nuclear antigen antibody. Immunohistochemistry also revealed anti-neuronal nitric oxide synthase, anti-S100 protein, antineuropeptide Y, and anti-cytokeratin immunoreactivity in tumour cells as well as in normal olfactory epithelium of goldfish control sections. Histopathological and immunohistochemical findings strongly suggest a diagnosis of an olfactory neuroblastoma (ONB). To our knowledge this is the first description of ONB in goldfish.
Assuntos
Doenças dos Peixes/patologia , Carpa Dourada , Neuroblastoma/veterinária , Neoplasias Nasais/veterinária , Animais , Neuroblastoma/patologia , Neoplasias Nasais/patologiaRESUMO
In this study, several neuropeptides were identified by immunohistochemistry in neuroendocrine cells (NEC) located in the gut epithelium and nerve cell bodies of the enteric nervous system of pejerrey Odontesthes bonariensis, a species that is a promising candidate for intensive aquaculture. The neuropeptides involved in orexigenic or anorexigenic action, i.e. gastrin, cholecystokinin-8, neuropeptide Y and calcitonin gene-related peptide (CGRP), displayed a significantly higher number of immunoreactive NECs in the anterior intestine, suggesting that this region of the gut plays an important role in the peripheral control of food intake. On the other hand, leu-enkephalin and vasoactive intestinal peptide (VIP), both associated with the modulation of the enteric immune system, showed no significant variations in the mean value of immunopositive NECs between the anterior and posterior intestine. This may indicate that their activity is required at a similar level along the entire gut. In addition, CGRP and VIP-immunoreactive neurons and nerve fibres were observed in the myenteric plexus, which might exert synergistic effects with the neuropeptides immunolocalized in NECs.
Assuntos
Mucosa Intestinal/metabolismo , Intestinos/citologia , Neuropeptídeos/metabolismo , Smegmamorpha/anatomia & histologia , Smegmamorpha/metabolismo , Animais , Imuno-Histoquímica , Intestinos/anatomia & histologia , Sistemas Neurossecretores/citologia , Sistemas Neurossecretores/metabolismoRESUMO
Rodlet cells are an enigmatic cell type described in tissues of both marine and freshwater teleosts. Although their structure is well established, up to date their function remains subject of debate. However, there is consensus among the majority of researchers that rodlet cells play an important role within immune system, and this function is probably related with the release of rodlets due to contractile capability of their fibrous layer. Regulation of the contraction mechanism would require proteins that modulate Ca(++) intracellular concentration to be expressed in rodlet cells. We performed a morphological and immunohistochemical study at light and electron microscopy levels to assess S100 protein immunoreactivity in developing rodlet cells. Immature stages did not exhibit immunoreactive signal; however, immunoreactivity was observed in the fibrous layer of both transitional and mature rodlet cells. The latter stage also showed immunosignal within the rodlets. These findings suggest a clear association between S100 protein expression and rodlet cell development that could be linked to the regulation of rodlet activity and contractile property of their fibrous layer. Furthermore, S100 protein antibody constitutes a novel marker for rodlet cells that could be used in future studies of this particular cell type.
Assuntos
Células Epiteliais/citologia , Células Epiteliais/metabolismo , Células Epiteliais/ultraestrutura , Linguados/crescimento & desenvolvimento , Linguados/metabolismo , Intestinos/citologia , Proteínas S100/metabolismo , Animais , Diferenciação Celular , Sistema Imunitário/citologia , Imuno-Histoquímica , Microscopia Eletrônica de Transmissão , Proteínas S100/imunologiaRESUMO
Para prescribir corrección en niños, además de considerar agudeza visual, integridad del segmento anterior y estado motor, se debe relacionar la magnitud y orientación del astigmatismo con la edad y el grupo étnico al cual pertenece el paciente.En ausencia de anisometropia, los astigmatismos con la regla deberían corregirse si son mayores de 2.50 dioptrías. Puesto que los astigmatismos contra la regla y oblicuos conllevan un mayor riesgo ambliopizante, se deben tener en cuenta magnitudes inferiores al dar la prescripción. En caso de anisometropías iguales o mayores a 1 dioptría se debe dar la corrección.
In order to prescribe correction in children, and afterconsidering visual sharpness, integrity of theanterior segment and motor state, there must beconsidered the magnitude and the orientation ofastigmatism regarding age and ethnic group of thepatient. When there is lack of anisometropy,astigmatism with rule should be corrected if theyare higher than 2.50 dioptres. As obliqueastigmatisms and against rule have a higherambliopizante risk, lower magnitudes might be takeninto account when giving prescription. In case ofanisometropy equal or higher to 1 dioptre correctionhas to be provided.
Assuntos
Astigmatismo , PrevalênciaRESUMO
Con el objetivo de establecer el resultado funcional del tratamiento quirúrgico de los pacientes afectados de parálisis cerebralm fundamentado en el análisis computarizado de la marcha (ACM) en el Instituto Roosevelt, se diseñó un estudio retrospectivo tipo serie de casos evaluando 24 características de la marcha, índice de consumo de energía, nivel funcional, evaluaciones de padres y pacientes, y destrezas ganadas o perdidas, basándonos en informes del laboratorio de marcha. Se evidenció mejoría en muchos de los parámetros, y deterioro en algunas características de la marcha. En su mayoría, los problemas residuales obedecieron a dificultades en la rehabilitación postoperatoria. Hubo altos niveles de satisfacción en el resultado obtenido. A pesar de las restricciones de diseño del estudio, los resultados indican que la intervención quirúrgica fundamentada en el ACM es efectiva y segura para los pacientes con PC.
Assuntos
Transtornos Neurológicos da Marcha , Processamento de Imagem Assistida por Computador , Paralisia Cerebral/cirurgia , Estudos RetrospectivosRESUMO
INTRODUCTION: In the cognitive sphere, alterations have been found in up to 65% of patients with multiple sclerosis (MS). Study of the P300 wave is a positive component of long latency related to cognitive function: amplitude with attention, and latency with the ability to process information. OBJECTIVE: To assess a study of the P300 wave in a group of patients with MS. PATIENTS AND METHODS: The P300 wave was studied in 26 patients, 22 women and 4 men, with definite clinical MS (on criteria of Poser et al), with normal motor and sensory conduction velocity studies. All patients had a battery of multi-modal evoked potentials (MEP), nuclear magnetic resonance imaging and immunological study of the cerebrospinal fluid. Seventeen patients had the exacerbation-remission (ER) and nine the primary progressive (PP) clinical forms of the disorder. RESULTS: The most markedly altered MEP were the visual and somatosensory evoked potentials (SSEP) of the patients with MS. When the types of clinical course were compared, the SSEP were statistically significant in the PP form, which may be explained by the greater spinal involvement of these patients. Comparative analysis of the P300 wave was done for 26 healthy patients of similar age and sex to that of the patients, and significant differences were found in P300 latency and amplitude between the MS and control groups. The patients who had had the disease for longer had significantly greater anomalies in the P300 waves. CONCLUSION: Study of the evolution of the P300 wave, which is cheap and easy to do, may be valuable in the evolutional assessment of cognitive changes in patients with MS.
Assuntos
Encéfalo/fisiologia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Potenciais Evocados P300/fisiologia , Esclerose Múltipla/complicações , Adolescente , Adulto , Encéfalo/patologia , Líquido Cefalorraquidiano/imunologia , Potenciais Somatossensoriais Evocados/fisiologia , Potenciais Evocados Visuais/fisiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/líquido cefalorraquidianoRESUMO
Some general features of the respiratory chain and respiratory control were characterized in coupled mitochondrial preparations from Leishmania mexicana promastigotes. O2 uptake was sensitive to the electron-transfer inhibitors rotenone, flavone, malonate, 4,4,4-trifluoro-1-(2-thienyl) 1.3 butanedione (TTFA), antimycin A, 2n-nonyl-4-hydroxyquinoline-N-oxide (HQNO), myxothiazol, cyanide and azide. A high concentration of rotenone (60 microM) was required to inhibit O2 uptake effectively. Difference spectra revealed the presence of cytochromes (a + a3), b and c. Respiratory control was stimulated 2-fold by ADP with different exogenous oxidizable substrates. Calculated ADP/O ratios were consistent with the notion that ascorbate/N,N,N',N'-tetramethylphenylenediamine (TMPD)-linked and FAD-linked respiration proceeds, respectively, with one third and two thirds of the ATP producing capacity of NADH-linked respiration. State 3 was suppressed by the ATP synthase inhibitors oligomycin and aurovertin and by the adenine nucleotide translocator inhibitors atractyloside and carboxy atractyloside. The protonophore carbonyl cyanide p-(trifluoromethoxy)phenylhydrazone (FCCP) provoked state 3u respiration. The mitochondrial preparation was capable of Ca2+ uptake and Ca2+ stimulated respiration. Data obtained suggests strongly that mitochondrial complexes I, II, III and IV are present in a major pathway of electron-transfer and that oxidative phosphorylation might proceed with high bioenergetic efficiency.
Assuntos
Leishmania mexicana/metabolismo , Mitocôndrias/metabolismo , Consumo de Oxigênio , Difosfato de Adenosina/metabolismo , Animais , Cálcio/metabolismo , Fracionamento Celular , Respiração Celular , Citocromos/metabolismo , Transporte de Elétrons/efeitos dos fármacos , Membranas Intracelulares/enzimologia , Membranas Intracelulares/metabolismo , Transporte de Íons/efeitos dos fármacos , Leishmania mexicana/enzimologia , Mitocôndrias/enzimologia , Translocases Mitocondriais de ADP e ATP/antagonistas & inibidores , Translocases Mitocondriais de ADP e ATP/metabolismo , NAD/metabolismo , Oxirredução , Fosforilação Oxidativa , Consumo de Oxigênio/efeitos dos fármacos , ATPases Translocadoras de Prótons/antagonistas & inibidores , ATPases Translocadoras de Prótons/metabolismo , Análise EspectralRESUMO
The mechanism responsible for the regulation of intracellular Na+ and K+ concentrations in trypanosomatids is unknown. In higher eukaryotes a ouabain-sensitive Na+,K(+)-ATPase located in the plasma membrane is the main mechanism for the regulation of the intracellular concentrations of Na+ and K+, while in trypanosomatids there are conflicting evidences about the existence of this type of ATPase. By the use of a highly enriched plasma membrane fraction, we showed that an ouabain-sensitive Na+,K(+)-ATPase is present in L. mexicana. The affinity of the enzyme for Na+ and K+ is similar to that reported for the mammalian Na+,K(+)-ATPase, showing also the same kinetic parameters regarding the relative concentration of those cations that give the optimal activity. Vanadate (10 microM) fully inhibits the ATPase activity, suggesting that the enzyme belongs to the P-type family of ionic pumps. The enzyme is sensitive to ouabain and other cardiac glycosides. These cardiac glycosides do not show any appreciable effect on the higher Mg(2+)-ATPase activity present in the same preparation. By the use of [3H]ouabain, we also show in this report that the binding of the inhibitor to the enzyme was specific. Taken together, these results demonstrate that an ouabain-sensitive Na+,K(+)-ATPase is present in the plasma membrane of Leishmania mexicana. Therefore, this Na+,K(+)-ATPase should participate in the intracellular regulation of these cations in Leishmania.
Assuntos
Leishmania mexicana/enzimologia , ATPase Trocadora de Sódio-Potássio/metabolismo , Animais , Membrana Celular/enzimologia , Inibidores Enzimáticos/farmacologia , Líquido Intracelular/metabolismo , Cinética , Leishmania mexicana/metabolismo , Ouabaína/farmacologia , Potássio/metabolismo , Sódio/metabolismo , ATPase Trocadora de Sódio-Potássio/antagonistas & inibidores , Vanadatos/farmacologiaRESUMO
The incidence of infection is increased in patients with cancer and certain hematologic disorders. We retrospectively reviewed all the patients evaluated for infection in our Hematology-Oncology unit during a six month period. The purpose of this study was to identify the most common organisms causing infection, evaluate the usefulness of tests performed as well as to determine the outcome and complications of therapy. Contrary to earlier experience the most common organisms causing bacteremia were gram-positive. Despite this finding, gram-negative organisms remained important pathogens specially of the respiratory and urine tract judging by their predominance in urine and sputum cultures. Of the commonly ordered tests, the chest X-ray was the most frequently positive test for infection and the complication rate of antibiotic therapy was 15%. We conclude that in addition to the traditional antibiotics effective against gram-negative organisms, institution of antibiotics effective against gram-positive organisms including Staphylococcus epidermides, should be considered early in the management of these patients.
Assuntos
Infecções Bacterianas/diagnóstico , Doenças Hematológicas/complicações , Hospitalização , Neoplasias/complicações , Antibacterianos/uso terapêutico , Infecções Bacterianas/etiologia , Infecções Bacterianas/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Humanos , Radiografia Torácica , Estudos Retrospectivos , Sepse/diagnóstico , Sepse/etiologia , Sepse/microbiologia , Escarro/microbiologia , Urina/microbiologiaRESUMO
Pseudomonas aeruginosa is an opportunistic, gram negative bacillus that causes serious hospital acquired infections. However, it also causes infections with unusual presentations which are acquired in a non-hospital environment. This report will discuss the pathogenesis, clinical manifestations, and therapy of this uncommon infection, such as: 1) Pseudomonas folliculitis: a superficial or deep bacterial infection associated with the use of public hot tubs, whirlpools and swimming pools. 2) Invasive external otitis: an infection that can progress to skull base mostly associated to elderly diabetic patients. It is usually secondary to aural irrigation with contaminated water. 3) Pseudomonas osteomyelitis: an infection usually associated with nail puncture wounds especially if wearing tennis shoes. 4) Toe with infection: mostly associated with individuals using topical antibacterial agents. 5) Green nail syndrome: a non tender paronychia lesion that appears most often in persons whose hands are constantly exposed to water, soaps and detergents or are subject to mechanical trauma. 6) Corneal ulcer keratitis: mostly associated with the use of soft lenses, eye drops, mascara or contaminated whirlpools. This condition may terminate in panophthalmitis. 7) Endocarditis: most commonly associated with intravenous drug addicts.
Assuntos
Infecções por Pseudomonas/diagnóstico , Úlcera da Córnea/diagnóstico , Endocardite Bacteriana/diagnóstico , Foliculite/diagnóstico , Dermatoses do Pé/diagnóstico , Humanos , Doenças da Unha/diagnóstico , Osteomielite/diagnóstico , Otite Externa/diagnóstico , Dedos do PéRESUMO
Leishmania braziliensis maintained very low (50 +/- 20 nM) intracellular concentrations of calcium ions under normal conditions, as shown by the fluorimetric indicator QUIN2. Digitonin-permeabilized cells liberated large amounts of calcium ions in the presence of the ionophore A23187, indicating the presence of a large intracellular reservoir for this ion. Given the extraordinary extension of the single giant mitochondrion of Kinetoplastida and the known capacity of mitochondria from other sources to accumulate calcium, we tested the capacity of this organelle to accumulate calcium ions in Leishmania. Coupled mitochondrial vesicles, five-fold enriched in succinate-cytochrome c oxidoreductase, were obtained from promastigotes by gentle grinding (45 s) with glass beads in hypertonic buffer solution, followed by differential centrifugation. These vesicles had a respiratory control ratio of 1.82 +/- 0.15, and two phosphorylation sites (sites II and III) using succinate as electron donor, and were capable of calcium uptake in the presence of several respiratory substrates; this uptake was enhanced in the presence of ADP and Pi and was blocked by classical electron transport inhibitors. Uncouplers such as carbonyl cyanide p-trifluoromethoxy-phenylhydrazone (FCCP) and the calcium ionophore A23187 released previously accumulated calcium ions, suggesting that the driving force for the calcium uptake by the vesicles is the respiratory generated electrochemical potential gradient of protons. A study of the affinity of this system for calcium showed that even at 90 microM free calcium, succinate-induced calcium uptake is not saturated while approaching a level of 200 nmol min-1 (mg protein)-1, indicating a low-affinity, large-capacity system.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Cálcio/metabolismo , Leishmania braziliensis/metabolismo , Leishmania/metabolismo , Mitocôndrias/metabolismo , Aminoquinolinas , Animais , Transporte Biológico , Fracionamento Celular , Transporte de Elétrons , Corantes Fluorescentes , Indicadores e Reagentes , Leishmania braziliensis/ultraestrutura , Naftalenossulfonatos , Consumo de OxigênioRESUMO
Conjoined twins are a rare obstetric event occurring 1/50,000 to 1/60,000 deliveries as a result of incomplete fission of the embryonic disc before the third week of pregnancy. They belong to the monochorionic-monoamniotic type of monozygotic twins and are classified according to the area of union, the most common site being the chest and upper abdomen (thoracopagus). Reported are two cases of thoracopagus twins in which the diagnosis was made prenatally by ultrasound in the second trimester of pregnancy. The most significant ultrasound findings included the demonstration of a single cardiac activity, the inability to separate the fetal bodies at their ventral portion, and a face-to-face fetal position. The pregnancies were allowed to continue until term with no significant prenatal complications, and an elective cesarean section was performed to avoid a traumatic delivery. In both cases the infants died during the first week of life because of cardiorespiratory insufficiency. The ultrasound criteria for the antenatal diagnosis of conjoined twins are reviewed, concluding that the careful ultrasound examination of all identified sets of twins, specially in those cases in which no separating membrane is demonstrated, is the cornerstone in making the prenatal diagnosis. In addition, ultrasound plays a crucial role not only in the diagnosis, but also in establishing the degree of conjoining, which is essential for planning an appropriate obstetrical and perinatal management.
Assuntos
Diagnóstico Pré-Natal , Gêmeos Unidos , Ultrassonografia , Adulto , Feminino , Humanos , Gravidez , Segundo Trimestre da Gravidez , Tórax/anormalidadesRESUMO
We performed a percutaneous mitral balloon valvuloplasty in 6 patients with severe mitral stenosis, aged 21 to 50 years. The mitral valve gradient decreased from 14.7 +/- 4.9 to 6.3 +/- 4.0 mmHg, p = 0.03. Mitral valve area increased in 5 patients (0.92 +/- 0.23 to 2.32 +/- 0.26 cm2, p = 0.04). One patient developed a transient cerebral ischemic attack without sequelae and mild mitral insufficiency. The diameter of the mitral annulus as measured by echocardiography was 48.5 +/- 8.1 mm, significantly larger than that reported in other series. The curvature of the transseptal needle was selected after an echocardiographic view of the inferior vena cava and atria from the subcostal window. This allowed a successful procedure in all patients regardless of cavity size.