RESUMO
ABSTRACT The objective was to evaluate the inoculation with Aspergillus terreus and/or Trichoderma longibrachiatum on fermentation, chemical and microbiological composition of elephant grass 'Cameroon' silage (Cenchrus purpureus). Treatments were A. terreus at 105 colony forming units (CFU)/g (AT15), T. longibrachiatum at 105 CFU/g (TL20), a mixture of both at 105 CFU/g (MIX), and a control group without inoculation (CONTR). The design was completely randomized with seven replicates. The MIX silage was most stable, while CONTR, AT15, and TL20, had lower dry matter losses. There was no effect of inoculation in the chemical composition of silages. Only MIX silage (4.40) had pH above the minimum of 4.2 for humid grass silage and above the control (4.05). Bacteria from Diplococcus genus was identified at the opening of TL20 and CONTR silages. After air exposure, the population of rods, Lactobacillus, and total lactic acid bacteria was higher in theTL20 and MIX. The inclusion of a T. longibrachiatum and A. terreus mixture increases dry mater loss and silage pH. T. longibrachiatum was more efficient in maintaining populations of total lactic acid bacteria after opening; therefore, this strain has potential as an additive for elephant grass 'Cameroon' silage.
RESUMO O objetivo foi testar a inoculação com Aspergillus terreus e Trichoderma longibrachiatum sobre a fermentação, a composição bromatológica e microbiológica de silagem de capim-elefante cultivar 'Cameroon' (Cenchrus purpureus). Os tratamentos foram A. terreus a 105 unidades formadores de colônias (UFC)/g (AT15), T. longibrachiatum a 105 UFC/g (TL20), a mistura de ambos a 105 UFC/g (MIX), cada, e um controle não inoculado (CONTR). O delineamento foi inteiramente ao acaso, com sete repetições. A silagem MIX foi mais estável após abertura, enquanto CONTR, AT15 e TL20 apresentaram menor perda de massa seca. Não houve efeito de inoculação sobre a composição bromatológica das silagens. Apenas a silagem MIX (4,40) apresentou pH acima do mínimo de 4,2 para silagem de capim úmido e superior ao controle (4,05). Bactérias do gênero Diplococcus foram identificadas na abertura das silagens TL20 e CONTR. Após exposição ao ar, a população de bastonetes, Lactobacillus e bactérias láticas totais foram maiores em TL20 e MIX. A mistura de T. longibrachiatum e A. terreus aumenta a perda de matéria seca e o pH da silagem. T. longibrachiatum é mais eficiente em manter as populações de bactérias láticas totais após a abertura. Portanto, essa cepa tem potencial como aditivo para silagem de capim-elefante 'Cameroon'.
RESUMO
INTRODUCTION: Rassi score (NYHA functional class III/IV HF [5 points], cardiomegaly [5 points], contractions abnormalities [3 points], non-sustained ventricular tachycardia [3 points], low amplitude QRS [2 points] and male sex [2 points]) is used in the clinic for risk stratification due to cardiovascular death in patients with Chagas disease (P-CD). Whether this score has any role in identifying patients at risk of complex ventricular arrhythmias has not been determined. OBJECTIVE: Assess whether there is an association between Rassi score and the presence of potentially malignant complex ventricular arrhythmias in P-CD. METHODS: 79 P-CD (34 men, age 61±11 years-old), consecutively referred for 24h-Holter were divided into 2 groups: low risk Rassi score (57 P, 0-6 points) and medium-high risk (22 P, 7-20 points). The amount and complexity of ventricular arrhythmia (> 30/ h, ventricular tachycardia [VT]), LVEF, heart rate turbulence (HRT) indexes (turbulence onset [TO] and turbulence slope [TS]) and HRT category (0 [without disautonomy], 1 and/or 2 [presence of disautonomy]) were evaluated. RESULTS: Compared to P-CD with low risk score, those with medium-high risk had more ventricular arrhythmias, lower LVEF, worse HRT indexes and more HRT categories 1 and/or 2 (see table below). CONCLUSIONS: 1) P-CD and Rassi score of medium to high risk have a greater amount of ventricular arrhythmias; 2) These findings can be explained by the presence of greater degree of disautonomy, assessed by HRT, and by the lower LVEF; 3) Prospective studies are necessary to confirm these findings in clinical practice.
Assuntos
Arritmias Cardíacas , Doença de ChagasRESUMO
Enteropatogenic Escherichia coli (EPEC) and shigatoxigenic E. coli (STEC), are generally poultry and poultry product isolate and can cause serious human infections. Many strains may become resistant to various antimicrobials, which can hinder the treatment of bacterial diseases. Organic farming seeks to avoid the selection and frequency of antimicrobial-resistant bacteria. This study aims to verify the resistance of EPEC and STEC from organic and conventional (industrial) broiler isolates to antimicrobials. All isolates were submitted to disk diffusion test with tetracycline, gentamicin, enrofloxacin, ceftriaxone and amoxicillin + clavulanate (TET, GEN, ENO, CTX, AMC) and PCR to detect specific virulence genes for EPEC and STEC. A total of 297 E. coli strains were isolated, 213 from conventional. In organic broiler, 84 strains were isolated. The strains from the conventional broiler isolates were resistant to five antimicrobials tested: TET 48.82% (104/213), ENO 28.17% (60/213), CTX 15.49% (33/213), GEN 14.55% (31/213), and AMC 7.04% (15/213), and 9.86% (21/213) were considered multidrug-resistant. Organic chicken strains were resistant to four of the antimicrobials tested: TET 35.7% (30/84), ENO 9.5% (8/84), CTX 2.4% (2/84), GEN 4.8% (4/84). Of the strains from the organic broiler chicken isolates, only 1.2% (1/84) was considered multidrug-resistant. No EPEC and STEC were found in the organic chicken samples. The multidrug resistance was characterized in 9.52% (2/21) of the EPEC and 4.76% (1/21) of the STEC. The study demonstrated the absence of EPEC and STEC strains in organic broilers and carcasses and a lower frequency of multiresistant strains compared to conventional breeding.(AU)
Assuntos
Galinhas/imunologia , Infecções por Escherichia coli/diagnóstico , Escherichia coli Enteropatogênica/patogenicidade , Anti-InfecciososRESUMO
Cheskidov et al. (2016 Commun. Math. Phys. 348, 129-143. (doi:10.1007/s00220-016-2730-8)) proved that physically realizable weak solutions of the incompressible two-dimensional Euler equations on a torus conserve kinetic energy. Physically realizable weak solutions are those that can be obtained as limits of vanishing viscosity. The key hypothesis was boundedness of the initial vorticity in [Formula: see text], [Formula: see text]. In this work, we extend their result, by adding forcing to the flow. This article is part of the theme issue 'Scaling the turbulence edifice (part 2)'.
RESUMO
AIM: To evaluate the bending, buckling and torsional resistance of ProGlider (PG) (Dentsply Sirona, Ballaigues, Switzerland), R-Pilot (RP) (VDW, Munich, Germany) and WaveOne Gold Glider (WOGG) (Dentsply Sirona). METHODOLOGY: Ninety instruments were used: 30 PG (size 0.16, .02v taper), 30 RP (size 0.125, .04 taper) and 30 WOGG (size 0.15, .02v taper). The bending resistance test was performed on 10 randomly selected instruments of each system according to ISO 3630-1 specifications. For the buckling resistance test, a loading was applied in the axial direction of each instrument using a universal test machine, with a 20 N cell and 15 mm min-1 speed, in the axial direction. When a lateral elastic displacement of 1 mm occurred, the force was registered. The torsional resistance test was performed according to ISO 3630-1 specifications. Statistical analysis was performed using one-way anova and post hoc Student-Newman-Keuls test (P < 0.05). RESULTS: WOGG had the lowest bending resistance, whilst RP had the highest bending resistance (P < 0.05). RP also had the highest buckling resistance, and WOGG had the lowest (P < 0.05). PG had intermediate results regarding bending and buckling resistance, with significant differences to RP and WOGG (P < 0.05). RP had the highest torsional strength and the lowest angular deflection when compared to PG and WOGG (P < 0.05). No differences in the torsional strength and angular deflection were observed between WOGG and PG (P> 0.05). CONCLUSION: The glide path instruments had different behaviours in term of bending, buckling and torsional resistance.
Assuntos
Instrumentos Odontológicos , Fenômenos Mecânicos , Ligas Dentárias , Desenho de Equipamento , Alemanha , Ouro , Humanos , Teste de Materiais , Preparo de Canal Radicular , Titânio , Torção MecânicaRESUMO
Helicoverpa armigera is the most significant pest of agriculture in Asia, Europe, Africa, and Australasia, causing damage to crops greater than US$2 billion annually and until 2013 it was not detected in Brazil. Helicoverpa zea is restricted to the American continent and is important to corn and a secondary pest of cotton and tomatoes. The wide range of crops exploited by H. armigera (mainly cotton, soybeans, chickpea, and corn), the possible mating between these species can promote population shifts, that could be assessed by RAPD-PCR technique. Therefore, the aim of this study was to determine the genetic diversity of H. armigera and H. zea populations by RAPD-PCR analysis. The most important result was the clustering of one H. armigera population in a group predominantly formed by H. zea. It could indicate a possible occurrence of an interspecific cross between these species. This is a concern to Brazilian agriculture due to the possibility of selection of hybrids well adapted to the American environment, which would be inherited from H. zea. The other noxious fact is the possible development of new biotypes resistant to insectides or Bt toxins expressed in transgenic crops, came from H. armigera gene pool.
Assuntos
Lepidópteros/genética , Polimorfismo Genético , Animais , Evolução Molecular , Hibridização GenéticaAssuntos
Hipertensão/diagnóstico , Medição de Risco/normas , Pressão Sanguínea , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etiologia , Colesterol/sangue , Medicina Baseada em Evidências , Feminino , Humanos , Hipertensão/complicações , Masculino , Fatores de Risco , Fatores SexuaisRESUMO
AIM: To evaluate the cyclic fatigue fracture resistance of engine-driven F2 ProTaper instruments under reciprocating movement. METHODOLOGY: A sample of 30 NiTi ProTaper F2 instruments was used. An artificial canal was made from a stainless steel tube, allowing the instruments to rotate freely. During mechanical testing, different movement kinematics and speeds were used, which resulted in three experimental groups (n = 10). The instruments from the first group (G1) were rotated at a nominal speed of 250 rpm until fracture, whilst the instruments from the second group (G2) were rotated at 400 rpm. In the third instrument group (G3), the files were driven under reciprocating movement. The time of fracture for each instrument was measured, and statistical analysis was performed using parametric methods. RESULTS: Reciprocating movement resulted in a significantly longer cyclic fatigue life (P < 0.05). Moreover, operating rpm was a significant factor affecting cyclic fatigue life (P < 0.05); instruments used at a rotational speed of 400 rpm (approximately 95 s) failed more rapidly than those used at 250 rpm (approximately 25 s). CONCLUSIONS: Movement kinematics is amongst the factors determining the resistance of rotary NiTi instruments to cyclic fracture. Moreover, the reciprocating movement promoted an extended cyclic fatigue life of the F2 ProTaper instrument in comparison with conventional rotation.
Assuntos
Equipamentos Odontológicos de Alta Rotação , Instrumentos Odontológicos , Endodontia/instrumentação , Análise de Falha de Equipamento , Preparo de Canal Radicular/instrumentação , Ligas Dentárias , Análise do Estresse Dentário , Teste de Materiais , Níquel , TitânioRESUMO
The autonomic nervous system plays an important role in physiological and pathological conditions, and has been extensively evaluated by parametric and non-parametric spectral analysis. To compare the results obtained with fast Fourier transform (FFT) and the autoregressive (AR) method, we performed a comprehensive comparative study using data from humans and rats during pharmacological blockade (in rats), a postural test (in humans), and in the hypertensive state (in both humans and rats). Although postural hypotension in humans induced an increase in normalized low-frequency (LFnu) of systolic blood pressure, the increase in the ratio was detected only by AR. In rats, AR and FFT analysis did not agree for LFnu and high frequency (HFnu) under basal conditions and after vagal blockade. The increase in the LF/HF ratio of the pulse interval, induced by methylatropine, was detected only by FFT. In hypertensive patients, changes in LF and HF for systolic blood pressure were observed only by AR; FFT was able to detect the reduction in both blood pressure variance and total power. In hypertensive rats, AR presented different values of variance and total power for systolic blood pressure. Moreover, AR and FFT presented discordant results for LF, LFnu, HF, LF/HF ratio, and total power for pulse interval. We provide evidence for disagreement in 23 percent of the indices of blood pressure and heart rate variability in humans and 67 percent discordance in rats when these variables are evaluated by AR and FFT under physiological and pathological conditions. The overall disagreement between AR and FFT in this study was 43 percent.
Assuntos
Animais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ratos , Adulto Jovem , Sistema Nervoso Autônomo/fisiopatologia , Análise de Fourier , Bloqueio Cardíaco/fisiopatologia , Hipertensão/fisiopatologia , Derivados da Atropina/farmacologia , Bloqueio Cardíaco/induzido quimicamente , Frequência Cardíaca/fisiologia , Ratos Endogâmicos SHR , Ratos Wistar , Índice de Gravidade de Doença , Teste da Mesa Inclinada , Adulto JovemRESUMO
The autonomic nervous system plays an important role in physiological and pathological conditions, and has been extensively evaluated by parametric and non-parametric spectral analysis. To compare the results obtained with fast Fourier transform (FFT) and the autoregressive (AR) method, we performed a comprehensive comparative study using data from humans and rats during pharmacological blockade (in rats), a postural test (in humans), and in the hypertensive state (in both humans and rats). Although postural hypotension in humans induced an increase in normalized low-frequency (LFnu) of systolic blood pressure, the increase in the ratio was detected only by AR. In rats, AR and FFT analysis did not agree for LFnu and high frequency (HFnu) under basal conditions and after vagal blockade. The increase in the LF/HF ratio of the pulse interval, induced by methylatropine, was detected only by FFT. In hypertensive patients, changes in LF and HF for systolic blood pressure were observed only by AR; FFT was able to detect the reduction in both blood pressure variance and total power. In hypertensive rats, AR presented different values of variance and total power for systolic blood pressure. Moreover, AR and FFT presented discordant results for LF, LFnu, HF, LF/HF ratio, and total power for pulse interval. We provide evidence for disagreement in 23% of the indices of blood pressure and heart rate variability in humans and 67% discordance in rats when these variables are evaluated by AR and FFT under physiological and pathological conditions. The overall disagreement between AR and FFT in this study was 43%.
Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Análise de Fourier , Bloqueio Cardíaco/fisiopatologia , Hipertensão/fisiopatologia , Animais , Derivados da Atropina/farmacologia , Feminino , Bloqueio Cardíaco/induzido quimicamente , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Ratos , Ratos Endogâmicos SHR , Ratos Wistar , Índice de Gravidade de Doença , Teste da Mesa Inclinada , Adulto JovemRESUMO
Malignant hypertension seems to be the consequence of very high blood pressure. Furthermore, an increase in sympathetic and renin-angiotensin system activity is considered to be the main mechanisms producing malignant hypertension. In the present study, 10 offspring of malignant hypertensive (OMH) parents (age 28 +/- 5 years, 7 males, 3 females, 2 white and 8 non-white) and 10 offspring of normotensive (ONT) parents (age 28 +/- 6 years, 2 males, 8 females, 3 white and 7 non-white) were evaluated. The OMH group had significantly higher (P < 0.05) casual blood pressure (125 +/- 10/81 +/- 5 mmHg) compared with ONT (99 +/- 13/67 +/- 5 mmHg). The increase in blood pressure was greater in OMH (Delta SBP = 17 +/- 2 vs Delta SBP = 9 +/- 1 mmHg in ONT) during cold pressor testing, but they had a lower increase in heart rate (Delta HR = 13 +/- 2 vs Delta HR = 20 +/- 3 bpm in ONT) during isometric exercise(handgrip test). Sympathetic activity, measured by microneurography, was significantly higher (P < 0.05) before exercise in OMH (17 +/- 6 vs 11 +/- 4 burst/min in ONT) and exhibited a greater increase (Delta = 18 +/- 10 vs Delta = 8 +/- 3 burst/min in ONT) during isometric exercise. This study showed increased sympathetic activity in OMH before exercise and a greater response during isometric exercise, suggesting an autonomic abnormality before exercise and a greater sympathetic response to physical stress in OMH compared to ONT.
Assuntos
Exercício Físico/fisiologia , Hipertensão Maligna/fisiopatologia , Estresse Fisiológico/fisiologia , Sistema Nervoso Simpático/fisiopatologia , Adulto , Estudos de Casos e Controles , Feminino , Frequência Cardíaca/fisiologia , Humanos , Hipertensão Maligna/sangue , Hipertensão Maligna/genética , Masculino , PaisRESUMO
Malignant hypertension seems to be the consequence of very high blood pressure. Furthermore, an increase in sympathetic and renin-angiotensin system activity is considered to be the main mechanisms producing malignant hypertension. In the present study, 10 offspring of malignant hypertensive (OMH) parents (age 28 ± 5 years, 7 males, 3 females, 2 white and 8 non-white) and 10 offspring of normotensive (ONT) parents (age 28 ± 6 years, 2 males, 8 females, 3 white and 7 non-white) were evaluated. The OMH group had significantly higher (P < 0.05) casual blood pressure (125 ± 10/81 ± 5 mmHg) compared with ONT (99 ± 13/67 ± 5 mmHg). The increase in blood pressure was greater in OMH (Ä SBP = 17 ± 2 vs Ä SBP = 9 ± 1 mmHg in ONT) during cold pressor testing, but they had a lower increase in heart rate (Ä HR = 13 ± 2 vs Ä HR = 20 ± 3 bpm in ONT) during isometric exercise (handgrip test). Sympathetic activity, measured by microneurography, was significantly higher (P < 0.05) before exercise in OMH (17 ± 6 vs 11 ± 4 burst/min in ONT) and exhibited a greater increase (Ä = 18 ± 10 vs Ä = 8 ± 3 burst/min in ONT) during isometric exercise. This study showed increased sympathetic activity in OMH before exercise and a greater response during isometric exercise, suggesting an autonomic abnormality before exercise and a greater sympathetic response to physical stress in OMH compared to ONT.
Assuntos
Adulto , Feminino , Humanos , Masculino , Exercício Físico/fisiologia , Hipertensão Maligna/fisiopatologia , Estresse Fisiológico/fisiologia , Sistema Nervoso Simpático/fisiopatologia , Estudos de Casos e Controles , Frequência Cardíaca/fisiologia , Hipertensão Maligna/sangue , Hipertensão Maligna/genética , PaisRESUMO
Leptin is produced primarily by adipocytes. Although originally associated with the central regulation of satiety and energy metabolism, increasing evidence indicates that leptin may be an important mediator in cardiovascular pathophysiology. The aim of the present study was to investigate plasma leptin levels in patient with Chagas' heart disease and their relation to different forms of the disease. We studied 52 chagasic patients and 30 controls matched for age and body mass index. All subjects underwent anthropometric, leptin and N-terminal pro-brain natriuretic peptide (NT-proBNP) measurements and were evaluated by echocardiography, 12-lead electrocardiogram (ECG), and chest X-ray. All patients had fasting blood samples taken between 8:00 and 9:00 am. Chagasic patients were divided into 3 groups: group I (indeterminate form, IF group) consisted of 24 subjects with 2 positive serologic reactions for Chagas' disease and no cardiac involvement as evaluated by chest X-rays, ECG and two-dimensional echocardiography; group II (showing ECG abnormalities and normal left ventricular systolic function, ECG group) consisted of 14 patients; group III consisted of 14 patients with congestive heart failure (CHF group) and left ventricular dysfunction. Serum leptin levels were significantly lower (P < 0.001) in the CHF group (1.4 ± 0.8 ng/mL) when compared to the IF group (5.3 ± 5.3 ng/mL), ECG group (9.7 ± 10.7 ng/mL), and control group (8.1 ± 7.8 ng/mL). NT-proBNP levels were significantly higher (P < 0.001) in the CHF group (831.8 ± 800.1 pg/mL) when compared to the IF group (53.2 ± 33.3 pg/mL), ECG group (83.3 ± 57.4 pg/mL), and control group (32 ± 22.7 pg/mL). Patients with Chagas' disease and an advanced stage of CHF have high levels of NT-ProBNP andlow plasma levels of leptin. One or more leptin-suppressing mechanisms may operate in chagasic patients.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Chagas/sangue , Insuficiência Cardíaca/sangue , Leptina/sangue , Disfunção Ventricular Esquerda/sangue , Índice de Massa Corporal , Biomarcadores/sangue , Estudos de Casos e Controles , Cardiomiopatia Chagásica/sangue , Ecocardiografia , Eletrocardiografia , Fluorimunoensaio , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangueRESUMO
Leptin is produced primarily by adipocytes. Although originally associated with the central regulation of satiety and energy metabolism, increasing evidence indicates that leptin may be an important mediator in cardiovascular pathophysiology. The aim of the present study was to investigate plasma leptin levels in patient with Chagas' heart disease and their relation to different forms of the disease. We studied 52 chagasic patients and 30 controls matched for age and body mass index. All subjects underwent anthropometric, leptin and N-terminal pro-brain natriuretic peptide (NT-proBNP) measurements and were evaluated by echocardiography, 12-lead electrocardiogram (ECG), and chest X-ray. All patients had fasting blood samples taken between 8:00 and 9:00 am. Chagasic patients were divided into 3 groups: group I (indeterminate form, IF group) consisted of 24 subjects with 2 positive serologic reactions for Chagas' disease and no cardiac involvement as evaluated by chest X-rays, ECG and two-dimensional echocardiography; group II (showing ECG abnormalities and normal left ventricular systolic function, ECG group) consisted of 14 patients; group III consisted of 14 patients with congestive heart failure (CHF group) and left ventricular dysfunction. Serum leptin levels were significantly lower (P < 0.001) in the CHF group (1.4 +/- 0.8 ng/mL) when compared to the IF group (5.3 +/- 5.3 ng/mL), ECG group (9.7 +/- 10.7 ng/mL), and control group (8.1 +/- 7.8 ng/mL). NT-proBNP levels were significantly higher (P < 0.001) in the CHF group (831.8 +/- 800.1 pg/mL) when compared to the IF group (53.2 +/- 33.3 pg/mL), ECG group (83.3 +/- 57.4 pg/mL), and control group (32 +/- 22.7 pg/mL). Patients with Chagas' disease and an advanced stage of CHF have high levels of NT-ProBNP andlow plasma levels of leptin. One or more leptin-suppressing mechanisms may operate in chagasic patients.
Assuntos
Doença de Chagas/sangue , Insuficiência Cardíaca/sangue , Leptina/sangue , Disfunção Ventricular Esquerda/sangue , Adulto , Biomarcadores/sangue , Índice de Massa Corporal , Estudos de Casos e Controles , Cardiomiopatia Chagásica/sangue , Ecocardiografia , Eletrocardiografia , Feminino , Fluorimunoensaio , Humanos , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangueRESUMO
We developed a new approach for the reconstruction of phylogenetic trees using ant colony optimization metaheuristics. A tree is constructed using a fully connected graph and the problem is approached similarly to the well-known traveling salesman problem. This methodology was used to develop an algorithm for constructing a phylogenetic tree using a pheromone matrix. Two data sets were tested with the algorithm: complete mitochondrial genomes from mammals and DNA sequences of the p53 gene from several eutherians. This new methodology was found to be superior to other well-known softwares, at least for this data set. These results are very promising and suggest more efforts for further developments.
Assuntos
Humanos , Animais , Algoritmos , Evolução Molecular , Filogenia , Simulação por Computador , DNA Mitocondrial/genética , Feromônios/genética , Formigas/genética , /genética , MamíferosRESUMO
Opportunistic infections, which affect acquired immunodeficiency syndrome (Aids) patients, are frequently disseminated and may cause bloodstream infections (BSI). The aim of this study was to evaluate the main causes of BSI in Aids patients with advanced stage of the disease, with special emphasis on the identification of fungemia. During a 21 months period, all patients with Aids (CD4 < 200) and febrile syndrome admitted to 3 university hospitals were systematically evaluated. For each patient presenting fever, a pair of blood cultures was collected and processed by using a commercial lysis-centrifugation system. One hundred and eleven patients (75 males) with a mean age of 36 years (median 33 years) and mean CD4 count of 64 cells/ml were included. Among the 111 patients evaluated we documented 54 episodes of BSI, including 46 patients with truly systemic infections and 8 episodes considered as contaminants. BSI were caused by gram-positive bacteria (43%), fungi (20%), gram-negative bacteria (15%), mycobacteria (15%), and mixed flora (7%). The crude mortality rate of our patients was 39%, being 50% for patients with BSI and 31% for the others. In conclusion, BSI are a common related to systemic infections on Aids patients with advanced stage of disease and is associated with a high rate of mortality.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Bacteriemia/microbiologia , Fungemia/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Adulto , Idoso , Contagem de Linfócito CD4 , Estudos Transversais , Feminino , Bactérias Gram-Negativas/classificação , Bactérias Gram-Positivas/classificação , Humanos , Masculino , Técnicas Microbiológicas/métodos , Pessoa de Meia-Idade , Prevalência , Índice de Gravidade de DoençaRESUMO
Opportunistic infections, which affect acquired immunodeficiency syndrome (Aids) patients, are frequently disseminated and may cause bloodstream infections (BSI). The aim of this study was to evaluate the main causes of BSI in Aids patients with advanced stage of the disease, with special emphasis on the identification of fungemia. During a 21 months period, all patients with Aids (CD4 < 200) and febrile syndrome admitted to 3 university hospitals were systematically evaluated. For each patient presenting fever, a pair of blood cultures was collected and processed by using a commercial lysis-centrifugation system. One hundred and eleven patients (75 males) with a mean age of 36 years (median 33 years) and mean CD4 count of 64 cells/ml were included. Among the 111 patients evaluated we documented 54 episodes of BSI, including 46 patients with truly systemic infections and 8 episodes considered as contaminants. BSI were caused by gram-positive bacteria (43 percent), fungi (20 percent), gram-negative bacteria (15 percent), mycobacteria (15 percent), and mixed flora (7 percent). The crude mortality rate of our patients was 39 percent, being 50 percent for patients with BSI and 31 percent for the others. In conclusion, BSI are a common related to systemic infections on Aids patients with advanced stage of disease and is associated with a high rate of mortality
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Infecções Oportunistas Relacionadas com a AIDS , Bacteriemia , Fungemia , Bactérias Gram-Negativas , Bactérias Gram-Positivas , Infecções Oportunistas Relacionadas com a AIDS , Bacteriemia , Estudos Transversais , Fungemia , Bactérias Gram-Negativas , Bactérias Gram-Positivas , Prevalência , Índice de Gravidade de DoençaRESUMO
Intrasacral meningoceles are rare conditions that can cause symptoms of nerve root compression. We report a case of a 18-year-old female, who presented with urinary incontinence. The neurological and urological evaluation revealed lack of detrusor muscle reflex. This finding supported the hypothesis of spinal disraphism. Magnetic resonance image revealed an intrasacral meningocele. The patient was submitted to surgical excision of the lesion without postoperative complications. In the present paper, the pathogenesis, clinical picture, neuroradiological findings and surgical treatment are discussed.
Assuntos
Meningocele/diagnóstico , Adolescente , Feminino , Humanos , Imageamento por Ressonância Magnética , Meningocele/diagnóstico por imagem , Meningocele/cirurgia , Radiografia , Sacro/diagnóstico por imagem , Sacro/patologia , Sacro/cirurgiaRESUMO
BACKGROUND: The peripheral and central chemoreflexes are important autonomic mechanisms for regulating breathing and cardiovascular function. Although pathological inflammatory infiltration of the peripheral chemoreceptors and central nervous system has been reported in Chagas' disease, functional evaluation of chemoreflexes has not yet been performed. METHODS AND RESULTS: The hypothesis that chemoreflex function is altered in patients with Chagas' heart disease (CH) but normal left ventricle function was tested in 12 CH patients and 13 matched control subjects. The ventilatory rate, minute ventilation, heart rate, mean arterial pressure, forearm blood flow, forearm vascular resistance, and venous norepi-nephrine responses to hypoxia and hypercapnia were determined. During hypoxia, the decrease in oxygen saturation was smaller in CH patients, despite a similar ventilatory response between groups. Both groups showed an increase in heart rate during hypoxia, but this response was blunted in CH patients. Although the mean arterial pressure response to hypoxia was similar in both groups, forearm vascular resistance significantly decreased in control subjects while remaining unchanged in CH patients. Moreover, a significant increase in plasma norepinephrine levels elicited by stimulation of peripheral chemoreceptors was observed only in the CH group. During hypercapnia, the increase in minute ventilation was smaller in CH patients, who did not exhibit the increase in norepinephrine observed in control subjects. CONCLUSIONS: These data suggest that CH potentiates respiratory, cardiovascular, and autonomic responses to peripheral chemoreceptor activation by hypoxia in patients with normal left ventricular function. The ventilatory and sympathetic responses to central chemoreceptor activation by hypercapnia, however, are significantly blunted.
Assuntos
Doenças do Sistema Nervoso Autônomo/fisiopatologia , Cardiomiopatia Chagásica/fisiopatologia , Células Quimiorreceptoras/fisiopatologia , Doenças do Sistema Nervoso Periférico/fisiopatologia , Reflexo Anormal , Adulto , Doenças do Sistema Nervoso Autônomo/complicações , Doenças do Sistema Nervoso Autônomo/diagnóstico , Velocidade do Fluxo Sanguíneo , Pressão Sanguínea , Capnografia , Cardiomiopatia Chagásica/complicações , Feminino , Antebraço/irrigação sanguínea , Antebraço/fisiopatologia , Frequência Cardíaca , Humanos , Hipercapnia/fisiopatologia , Hiperóxia , Hipóxia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Norepinefrina/sangue , Oximetria , Doenças do Sistema Nervoso Periférico/complicações , Doenças do Sistema Nervoso Periférico/diagnóstico , Ventilação Pulmonar , Resistência Vascular , Função Ventricular EsquerdaRESUMO
Malignant hypertension is a serious form of arterial hypertension in which the physiopathological mechanisms include increased activity of the sympathetic nervous system, renin angiotensin system, and endothelium dysfunction. Family history of hypertension is an important predictive factor for hypertension and is associated with metabolic and hemodynamic abnormalities. Studies of these abnormalities in malignant hypertensive offspring have not yet been published. Therefore, we studied 42 offspring of malignant hypertensive parents (OMH group: age, 22+/-7 years; 23 male subjects; 27 white) and 35 offspring of normotensive parents (ONT group: age, 21+/-4 years; 23 male subjects; 25 white). All subjects had blood pressure <140/90 mm Hg. We evaluated body mass index; office blood pressure; 24-hour ambulatory and continuous beat-to-beat blood pressure monitoring (Finapres); biochemical analysis, including total cholesterol and fractions, triglycerides, glucose, and insulin; and hormonal analysis, including plasma renin activity, aldosterone, and catecholamines. The subjects were also submitted to cold pressure test and handgrip measurements. The body mass index was significantly higher in the OMH group (24+/-5 kg/m(2)) than in the ONT group (22+/-4 kg/m(2)). The OMH group showed significantly higher blood pressure and heart rate in office and Finapres measurements (P<0.05). In 24-hour ambulatory monitoring, the OMH group presented higher 24-hour blood pressure and heart rate, higher blood pressure during the night, and higher heart rate variability during the day compared with those of the ONT group. They also presented lower HDL cholesterol, higher levels of plasma insulin and norepinephrine, and higher insulin-to-glucose ratio (P<0.05) than the ONT group. There were no differences in the other biochemical parameters measured. In conclusion, OMH subjects show early hemodynamic, neurohumoral, and metabolic alterations that are typical of hypertensive metabolic syndrome.