RESUMO
Resumen Introducción. En todos los procesos químicos se requiere de un medio de reacción o solvente, y dichos solventes orgánicos son altamente volátiles por lo que son contaminantes de la atmósfera, y se requieren nuevos métodos, procesos y otro tipo de solventes que minimice dicha contaminación, y los líquidos iónicos están resultando ser una gran alternativa a dicho problema. Objetivo. Sintetizar líquidos iónicos a base del imidazol con aniones tanto inorgánicos como orgánicos y evaluar su potencial aplicación como catalizadores en reacciones importantes de síntesis orgánicas, como la síntesis asimétrica, específicamente la condensación aldolica. Materiales y métodos. El metil imidazol (99%), 1-bromobutano (97%), prolina (98%), KOH (97%), acetato de etilo, etanol, grado reactivo, fueron suministrados por Sigma Chemical Co. Se utilizó el metil imidazol; para la síntesis de líquido iónico base el bromuro de butil-metil-imidazol, [Bmim][Br]; los demás líquidos iónicos se obtienen por reacción de metátesis, para obtener el hidroxi de butil-metil-imidazol, [Bmim][OH], y el prolinato de butil-metil-imidazol, [Bmim][Pro]; estos líquidos fueron utilizados como catalizadores en la reacción de síntesis asimétrica como la condensación aldolica. Resultados. Se realizó una condensación aldolica clásica, p-nitrobenzalhedido con ciclohexanona para probar los líquidos iónicos sintetizados como catalizadores, y al comparar los resultados obtenidos con métodos convencionales se observan ventajas, como altos rendimientos y alta selectividad en menor tiempo de reacción. Conclusiones. En condiciones muy suaves de reacción, se logró reutilizar hasta 6 veces el líquido iónico como catalizador de la reacción sin perder las ventajas mencionadas, lo que lo hace un sistema sostenible.
Abstract Introduction. In all chemical processes, a reaction medium or solvent is required, and such organic solvents are highly volatile so they are pollutants to the atmosphere, and new methods, processes and other solvents are required to minimize the contamination, and Ionic liquids are proving to be a great alternative to such problem. Objective. Synthesize imidazole based ionic liquids with both inorganic and organic anions and evaluate their potential application as catalysts in important reactions of organic synthesis, such as asymmetric synthesis, specifically in asymmetric aldol reaction. Materials and Methods. Methyl imidazole (99%), 1-bromobutane (97%), proline (98%), KOH (97%), Ethyl acetate, ethanol, reagent grade were supplied by Sigma Chemical Co. It was used the methyl imidazol for the synthesis of the ionic liquid butyl methyl imidazole bromide, [Bmim] [Br], and the other ionic liquids were obtained by metathesis reaction from such ionic liquid, to obtain the butyl methyl imidazole hydroxy [Bmim] [OH], and the butyl methyl imidazole prolinate, [Bmim] [Pro]. These ionic liquids were used as catalysts in the asymmetric aldol reaction. Results. A classical aldol reaction, p-nitrobenzaldehyde with cyclohexanone was performed to test the ionic liquids synthesized as catalysts, and when comparing the results obtained with conventional methods, advantages were observed, such as high yields and high selectivity in less time reaction. Conclusions. Under very mild reaction conditions, it was possible to reuse up to 6 times the ionic liquid as a reaction catalyst without losing the mentioned advantages, which makes it a sustainable system.
Resumo Introdução. Todos os processos químicos requerem um meio de reação ou solvente, tais solventes orgânicos são altamente voláteis, é assim que são os poluentes principais da atmosfera, porem precisa-se de novos métodos, processos e outros solventes para minimizar a contaminação, por isso, os líquidos iónicos estão provando para ser uma ótima alternativa para esse problema. Objetivo. A sínteses dos líquidos iónicos com base em imidazol e usando ânions inorgânicos e orgânicos e avaliar sua potencial aplicação como catalisadores em reações importantes em síntese orgânica, tais como a síntese assimétrica, especificamente a condensação aldólica. Materiais e Métodos. O imidazol metil (99%), 1-bromobutano (97%), prolina (98%), KOH (97%), acetato de etila e etanol no grau de reagente, foram fornecidos pelo Sigma Chemical Co. O metila-imidazol foi utilizado para a síntese baseado no líquido iónico brometo de metil-butil-imidazo-, [BMIM] [Br], Os outros líquidos iónicos são obtidos por reação de metátese, para se obter o hidroxi de butil-metil-imidazol, [BMIM][OH], e prolinato de butil-metil-imidazol, [BMIM][Pro], estes líquidos foram usadas como catalisadores na reação de síntese assimétrica, como a condensação aldólica. Resultados. Foi realizada uma condensação aldólica clássica usando p-nitrobenzaldeído com a cicloexanona para testar os líquidos iónicos sintetizados como catalisador, ao comparar os resultados obtidos com os métodos convencionais darão vantagens, tais como rendimentos elevados e alta seletividade é observada no tempo de reação mais rápido. Conclusões. Nas condições muito suave de reação, foi possível reutilizar até 6 vezes o líquido iónico como catalisador da reação, sem perder as vantagens mencionadas, tornando-se um sistema sustentável.
RESUMO
Three obese patients underwent sleeve gastrectomy. They developed gastric dehiscence with generalized peritonitis, sepsis and shock, being operated as total gastrectomy of the remanent stomach with Roux in Y esophago-jejunostomy reconstruction as a last chance of life saving procedure.
Assuntos
Gastrectomia/métodos , Derivação Gástrica , Sepse/cirurgia , Deiscência da Ferida Operatória/cirurgia , Adulto , Feminino , Derivação Gástrica/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Sepse/etiologiaRESUMO
Presentamos la experiencia de tres pacientes obesos que fueron sometidos a tratamiento quirúrgico de manga gástrica y que desarrollaron dehiscencia de sutura gástrica con peritonitis generalizada, sepsis y shock por lo que fueron sometidos a degastrectomía total (resección del remanente gástrico) y reconstrucción inmediata de esófago yeyuno anastomosis en Y de Roux como última medida de tratamiento salvador de vida.
Three obese patients underwent sleeve gastrectomy. They developed gastric dehiscence with generalized peritonitis, sepsis and shock, being operated as total gastrectomy of the remanent stomach with Roux in Y esophago-jejunostomy reconstruction as a lastchance of life saving procedure.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Deiscência da Ferida Operatória/cirurgia , Fístula Gástrica , Laparoscopia , Obesidade Mórbida/cirurgia , Procedimentos de Cirurgia Plástica , SepseRESUMO
PURPOSE: To evaluate the early and late cardiorespiratory responses after balloon mitral valvuloplasty. METHODS: Nine female patients aged 35 +/- 9 years with mitral stenosis, in class II or III (NYHA) underwent up-right ergoespirometric test, resting electrocardiogram and echocardiogram before, 3 to 5 days (early evaluation) and 8 to 12 months (late evaluation) after mitral valvuloplasty. All patients were treated with digitalis and diuretics. RESULTS: During late evaluation, 44% patients were in class II and 56% were in class I (NYHA). The resting heart rate decreased (87 +/- 11 bpm vs 85 +/- 7 bpm vs 75 +/- 9 bpm) and the number of steps increased (4 +/- 1 steps vs 5 +/- 2 steps vs 6 +/- 1 steps); the peak oxygen uptake improved only in the late evaluation (16 +/- 3 mL/kg/min vs 18 +/- 4 mL/kg/min vs 22 +/- 7 mL/kg/min). The anaerobic threshold, minute ventilation (VE) and ventilatory equivalent for oxygen showed no change. The heart rate (1st step: 124 +/- 18 bpm vs 112 +/- 13 bpm vs 87 +/- 15 bpm), O2 uptake (1st step: 10 +/- 2 mL/ kg/min vs 8 +/- 2 mL/kg/min vs 8 +/- 2 mL/kg/min) and VE decreased during submaximal exercise in early and late phases. The mitral valve area decreased in the late evaluation (0.94 cm2 vs 1.66 cm2 vs 1.20 cm2). CONCLUSION: Although partial restenosis tended to occur in these patients, they improved the functional class and cardiorespiratory performance and cardiocirculatory load during submaximal exercise.
Assuntos
Cateterismo , Estenose da Valva Mitral/terapia , Adulto , Limiar Anaeróbio , Análise de Variância , Teste de Esforço , Feminino , Seguimentos , Humanos , Consumo de Oxigênio , Período Pós-Operatório , Cuidados Pré-Operatórios , Ventilação Pulmonar , Espirometria , Fatores de TempoRESUMO
OBJETIVO - avaliaçäo näo invasiva das respostas cardiopulmonares ao exercício a curto e longo prazo após valvotomia por cateter baläo. MÉTODOS - Estudaram-se 9 pacientes do sexo feminino, 35ñ9 anos, com estenose mitral, tipo funcional II ou III, em uso de digitálicos e diuréticos, através de teste ergoespirométrico, eletrocardiograma e ecocardiograma, antes e após valvotomia em fase precoce (3 a 5 dias) e tardia (8 a 12 meses). RESULTADOS - Os pacientes evoluíram para tipo funcional II (44 por cento) ou I (56 por cento), na fase tardia. Houve reduçÝo da freqüência cardíaca de repouso (87ñ11bpm vs 85ñ7bpm vs 75ñ9bpm) e elevaçäo do número de estágios (4ñ1 estágios vs 5ñ2 estágios vs 6ñ1 estágios); a capacidade aeróbica máxima aumentou apenas na fase tardia (16ñ3mL/kg/min vs 18ñ4mL/kg/min vs 22ñ7mL/kg/min). O limiar anaeróbico, a ventilaçäo pulmonar e o equivalente ventilatório do O2 (Oxigênio 2) permaneceram inalterados. Nas cargas submáximas de exercício ocorreu reduçäo da freqüência cardíaca (estágio I: 124ñ18bpm vs 112ñ13bpm vs 87ñ15bpm), consumo de O2 (Oxigênio 2) (estágio I: 10ñ2mL/kg/min vs 8ñ2mL/kg/min vs 8ñmL/kg/min) e ventilaçäo pulmonar, nas fases precoce e tardia. A área valvar mitral mostrou reduçöes na fase tardia (0,94cm² vs 1,66cm² vs 1,20cm²). CONCLUSÄO - Apesar da tendência à reestenose parcial, houve melhora no tipo funcional e no desempenho cardiopulmonar com diminuiçäo da sobrecarga circulatória no exercício submáximo.
Assuntos
Humanos , Feminino , Adulto , Cateterismo , Teste de Esforço , Estenose da Valva Mitral/terapia , Limiar Anaeróbio , Seguimentos , Período Pós-Operatório , Fatores de TempoRESUMO
The goal of this study was to assess left ventricular segmental wall motion (SWM) abnormalities during coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB), and its impact on the immediate postoperative outcome. Transesophageal echocardiography was used intraoperatively in 27 patients (mean age 57 years) who had CABG without CPB. Images obtained with a 5-MHz biplane transesophageal echocardiographic probe in the transgastric and transesophageal planes were recorded before, during, and after 48 coronary artery clampings for saphenous vein or internal mammary artery anastomosis. Transthoracic echocardiography was performed 1 day before surgery and on the seventh postoperative day. During the 48 coronary artery clampings, 31 (64%) new SWM abnormalities were found. At the time of chest closure, complete recovery occurred in 16 (50%) segments, partial recovery in 10 (33%), and no recovery in 5 (17%). On the seventh postoperative day the new SWM abnormalities persisted in all 5 segments without recovery at the end of the surgery and in 2 of 10 (20%)segments with partial recovery (group 1). Group 1 had higher variation on the echocardiographic point score index between the beginning and end of surgery, higher enzymatic levels, more ST-T changes on the electrocardiogram, and more clinical problems than group 2 (patients without new SWM abnormalities on the seventh postoperative day) (P < .05). We concluded that new SWM abnormalities of the left ventricle occur during CABG without CPB as assessed by intraoperative transesophageal echocardiography. Persistence of these abnormalities at the end of surgery may be a predictor of SWM dysfunction and clinical problems in the immediate postoperative period.
Assuntos
Ponte Cardiopulmonar , Ponte de Artéria Coronária , Ecocardiografia Transesofagiana , Adulto , Idoso , Feminino , Humanos , Complicações Intraoperatórias , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/etiologiaRESUMO
PURPOSE: To evaluate whether the enalaprilat, an angiotensin converting enzyme inhibitor, was able to prevent the myocardial damage induced by doxorubicin (DOX). METHODS: Four groups composed of 10 Wistar rats each were followed for seven weeks: control (CONT); treated with enalaprilat (ENA, 1mg/kg/d/sc) treated with doxorubicin (DOX, 25 mg/kg/d/sc), and treated with doxorubicin plus enalaprilat (DOX+ENA). In eight animals of each group, the left ventricle (LV) was prepared for morphometric study and stained with HE and picro-sírius for identifying muscle fibers and collagen. In each group three fragments of the LV were examined with electronic microscopy (EM). For statistical analysis: the one-way analysis of variance was performed and was followed by multiple comparisons test when the difference between groups were detected p values < or = 0.05 were considered significant. RESULTS: Light microscopy-it was not found any significant difference among the groups for muscle fibers patterns and proportion of collagen fibers of left ventricle. Electronic microscopy-the cristolysis index (proportion between normal and damage mitochondria) demonstrated significant difference between DOX and DOX+ENA groups (30.1 vs 11.6, p < or = 0.01). CONCLUSION: ENA prevented cardiotoxic alterations induced by DOX minimizing the aggression to the mitochondria and these findings, if confirmed in anima nobilis, may open a new clinical use for this type of drug.
Assuntos
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Cardiomiopatias/prevenção & controle , Doxorrubicina/efeitos adversos , Enalaprilato/uso terapêutico , Animais , Cardiomiopatias/induzido quimicamente , Ratos , Ratos WistarRESUMO
A 11 years-old male child, with supravalvar aortic stenosis who had as complications aortic endarteritis and mycotic aneurysm formation in the ascending aorta. The aneurysms were diagnosed by a control echocardiogram at the end of an apparently successful clinical treatment of endocarditis. Angiography confirmed the diagnosis and the aneurysms were surgically resected. Six months after surgery the patient is doing well.
Assuntos
Aneurisma Infectado/etiologia , Estenose da Valva Aórtica/complicações , Endarterite/microbiologia , Endocardite Bacteriana/complicações , Aneurisma Infectado/diagnóstico , Aneurisma Infectado/cirurgia , Criança , Angiografia Coronária , Ecocardiografia Doppler , Eletrocardiografia , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/terapia , Seguimentos , Humanos , MasculinoRESUMO
A two-year-old male child presenting anomalous origin of the left coronary artery diagnosed by Doppler echocardiography and confirmed by angiography developed an ischemic stroke, which is a rare event in this situation. He [correction of She] had good recovery of the neurological deficit and his anomalous artery was successfully reimplanted.
Assuntos
Transtornos Cerebrovasculares/etiologia , Anomalias dos Vasos Coronários/complicações , Encéfalo/diagnóstico por imagem , Transtornos Cerebrovasculares/diagnóstico , Pré-Escolar , Anomalias dos Vasos Coronários/diagnóstico , Ecocardiografia Doppler , Eletrocardiografia , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
Valvular function, assessed by Doppler technique, has not been extensively investigated during normal pregnancy. To prospectively study this feature, 18 normal pregnant women were followed during their pregnancies and puerperium, with serial clinical and pulsed-continuous Doppler echocardiographic examinations. In four gestational periods and the puerperium, we analysed: (a) ventricular and atrial dimensions, as well as valve annular diameters; (b) prevalence and characteristics of trivial valvular regurgitations. During pregnancy, slight but significant increases of the four cardiac chamber dimensions and valve annular diameters were observed, except for the aortic ring. The prevalence of physiologic valvular regurgitation in early pregnancy (mitral, 0%; tricuspid, 38.9%; pulmonary, 22.2%; aortic, 0%), was similar to a control group of 18 healthy non-pregnant women. As pregnancy evolved, there was a progressive and significant increase of multivalvular regurgitation, maximal at full-term (mitral, 27.8%; tricuspid, 94.4%; pulmonary, 94.4%, P < 0.05 vs. early pregnancy). Aortic regurgitation was not detected in any stage of pregnancy. In the puerperium, mitral regurgitation resolved, but tricuspid and pulmonary regurgitation were still significantly prevalent (83.3% and 66.7%, respectively, P < 0.05 vs. early pregnancy). It is concluded that physiologic multivalvular regurgitation is frequent in pregnancy, mainly involving right-sided valves in late gestational periods, occasionally persisting in the early puerperium. Chamber enlargement, valve annular dilatation, and increased prevalence of trivial valve regurgitation are time-related events during normal pregnancy, resulting from a reversible cardiac remodeling process induced by physiologic volume overload. These aspects should be considered for a correct interpretation of Doppler echocardiographic findings in pregnant women with suspected heart disease.
Assuntos
Doenças das Valvas Cardíacas/diagnóstico por imagem , Complicações Cardiovasculares na Gravidez/diagnóstico por imagem , Adolescente , Adulto , Velocidade do Fluxo Sanguíneo/fisiologia , Volume Cardíaco/fisiologia , Ecocardiografia Doppler , Feminino , Idade Gestacional , Doenças das Valvas Cardíacas/fisiopatologia , Valvas Cardíacas/diagnóstico por imagem , Valvas Cardíacas/fisiopatologia , Hemodinâmica/fisiologia , Humanos , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/fisiopatologia , Gravidez , Complicações Cardiovasculares na Gravidez/fisiopatologia , Estudos Prospectivos , Insuficiência da Valva Pulmonar/diagnóstico por imagem , Insuficiência da Valva Pulmonar/fisiopatologia , Valores de Referência , Insuficiência da Valva Tricúspide/diagnóstico por imagem , Insuficiência da Valva Tricúspide/fisiopatologiaRESUMO
Se analizan y estudian los tipos de drogas alucinógenas utilizadas por los niños de la calle de Sao Paulo, Brasil y su relación con cambios electrocardiográficos e infección con Mycoplasma pneumoniae en esta población. Palabras claves: Niños de la calle, EGK, M pneumoniae.
Assuntos
Humanos , Masculino , Adolescente , Feminino , Criança , Alucinógenos/análise , Cardiopatias , Jovens em Situação de Rua , Mycoplasma pneumoniae , Doenças Respiratórias , Drogas Ilícitas , BrasilRESUMO
The correct identification of the left and right fascicles blocks of the His bundle will permit to explain different patterns of the ECG and VCG. The differentiation between the right peripheral bundle branch and the left bundle branch division is not only important in anatomic and physiologic grounds, but also in a clinic viewpoint. So, trying to refine the diagnostic criteria and improve the recognition of these intraventricular conduction disturbances, we developed this study. Eighty five patients were evaluated and divided into two groups. Group I included 65 patients with cardiac disease; group II consisted of 20 normal subjects taken as a control. Some classic ECG and VCG criteria were tested as well as new ones. We confirmed the significance of the S2/S3 relation to distinguish the right superior divisional block (RSDB) from the left anterior hemiblock (LAH), and added some new criteria: 1) C morphology in horizontal plane (HP) to the right divisional block (RDB); 2) assessment of aVL lead to separate RSDB from LAH--qR pattern in the last, and different one to RSDB; 3) the qR' pattern in L2, L3 and aVF leads associated with left ventricular hypertrophy (LVH) pattern screened the left posterior hemiblock (LPH). We found no significance in R3/R2 relation to the right inferior divisional block (RIDB). Similarly to what happened to the left bundle branch block in the 70's decade, we expect that an adequate assessment of the RDB can permit a better understanding of its real clinical value.