Caracterização e tratamento do efluente de uma estação de serviço

O presente estudo incidiu na caracterização e tratamento das lamas retidas nos separadores de hidrocarbonetos instalados numa estação de serviço. Recorreu-se à técnica de respirometria para obter informação prévia sobre a toxicidade e a tratabilidade das lamas por um Sequencial Batch Biofilm Reactor (SBBR). Utilizou-se um inóculo de lamas activadas e uma cultura de Pseudomonas putida. Os testes respirométricos permitiram avaliar a capacidade destas culturas crescerem num meio contendo hidrocarbonetos como única fonte de carbono e verificar o efeito de diferentes concentrações de substrato na actividade microbiana.Instituto de Biotecnologia e Química Fina (IBQF); programa PRAXIS

Reação de linhagens de feijoeiro de oito ciclos de seleção recorrente visando a resistência à Pseudocercospora griseola a dois isolados do patógeno.

A mancha angular incitada pelo fungo Pseudocercospora griseola é um dos principais problemas da cultura do feijoeiro em algumas regiões do Brasil. Visando a obter linhagens resistentes a esse patógeno, um programa de seleção recorrente vem sendo conduzido há alguns anos pela Universidade Federal de Lavras (UFLA) e Embrapa Arroz e Feijão. Esse trabalho visa avaliar o desempenho de linhagens obtidas nos diferentes ciclos seletivos, sob condições de casa de vegetação, com relação a dois isolados de P griseola

Biventricular Takotsubo vs Myocarditis – a diagnostic challenge

Background: Takotsubo cardiomyopathy (TCM) is an important differential diagnosis of acute coronary syndrome and myocarditis. It is characterized by normal or near-normal coronary arteries and regional wall motion abnormalities that extend beyond a single coronary vascular bed. Variants of the classical left ventricular (LV) apical ballooning are increasing in recognition as cardiac magnetic resonance (CMR) is more extensively used. Case report: We present a case of 69-year-old woman with a previous history of hypertension, diabetes and dyslipidaemia, transferred to our emergency department due to suspected acute coronary syndrome. She had a history of two episodes of an oppressive chest pain longer than 1 hour, orthopnoea and paroxysmal nocturnal dyspnoea 36 hours before. Two weeks before she had had a lower tract respiratory infection, that was not totally resolved. On admission, she only had dyspnoea. On examination, she had wheezing, arrhythmic pulse and hypertension. Breath sounds were absent in lower chest and rales were also noted. Electrocardiogram showed rapid atrial fibrillation, poor R wave progression in anteroseptal leads and inverted T waves in I, aVL and V2-V6 leads. Modest elevation in cardiac troponin (4.55 ng/mL) was observed. Chest x-ray showed bilateral pleural effusion. A transthoracic echocardiography (TTE) was immediately performed and revealed akinesis/dyskinesis of mid to apical segments (apical ballooning) of both ventricles, extended beyond a single epicardial coronary distribution, compatible with biventricular TCM. Cardiac catheterization showed absence of obstructive coronary disease. A CMR, performed two days later, showed moderate biventricular systolic dysfunction, hypokinesis in mid to apical segments of LV and hypokinesis in apical right ventricle. It also showed non-ischemic late gadolinium enhancement in antero-apical and lateral apical segments. After several days of medical management, the patient was discharged from the hospital in stable condition. TTE performed 6-month after evidenced complete biventricular function recovery and no segmental contractility changes. CMR supported the functional recovery and the resolution of contractility abnormalities, but noticed the intramyocardial late gadolinium enhancement in the segments previously reported. Conclusion: There are fewer reports of this unusual presentation of TCM, described by ETT. This case represents a good example of the diagnostic challenge between myocarditis and takotsubo cardiomyopathy. Taking in account the exuberance of the case, the mild elevation of troponin, the full recovery of biventricular function and resolution of contractility abnormalities, it seems more probably to be a TCM, in a patient who, probably had a previous scar of myocarditis. Although, the hypothesis of acute myocarditis as the primary diagnosis cannot be excluded

Prevalence of conventional cardiovascular risk factors in patients with acute coronary syndrome

Background: Primary prevention studies have shown that early detection and aggressive treatment of cardiovascular risk factors (CRF) prevent cardiovascular events. It is not well described the prevalence of CRF in patients, at the moment of admission due to acute coronary syndrome (ACS). Aim: To determine the prevalence of CRF among patients admitted with ACS. Methods: We analysed 4871 patients admitted consecutively in our coronary care unit with a diagnosis of ACS and included in a prospective registry, from January 2002 to October 2013. We studied the prevalence of conventional risk factors (diabetes, hypertension, smoking, dyslipidaemia) and compared findings according to gender and type of ACS: ACS with ST elevation (STEMI), ACS without ST elevation (NSTEMI). Results: Men represented 75% (n=3658) of the total population, were younger than women (61.6±12,9 vs 70.9 ±11.8 years; p<0.001) and had more frequently body mass index ≥ 25 kg/m2 (70.9% vs 62.3%; p<0.001). The most frequent CRF was hypertension (62.4%; n=3038), followed by dyslipidaemia (50.6%, n=2467), smoking (43.2%; n=2106) and diabetes (27.2%; n=1324). In women, the more common CRF were hypertension (75%) and dyslipidaemia (51.2%), whereas in men were smoking (54.4%) and dyslipidaemia (50.5%). We identify, at least, one CRF in 92,4% of all patients and two or three risk factors in 58.1%. Women had more frequently 2 CRF than men (40.1% vs 36.3%; p=0.011), although mean had, more often, 4 CRF (8.9% vs 4.1%; p<0.001). Previous history of cerebrovascular disease was more observed in women (8.6% vs 6.1%; p=0.002), but men had more often history of previous revascularization (9.8% vs 6.8%; p<0.001). On admission men presented more frequently STEMI (50.8% vs 43.5%; p<0,001) and less frequently renal dysfunction (17.2% vs 39.6%; p<0.001) and anaemia (18.8% vs 33.3%; p<0.001). Hypertension was the most prevalent CFR as in patients STEMI (56.6%) as in NSTEMI patients (67.9%), followed by smoking (47.5%) in STEMI patients and by dyslipidaemia (55.7%) in NSTEMI patients. Conclusion: We found at least one CRF in 92.8% of patients and two or three in more than half. Hypertension emerged as the major CRF in both forms of presentation of ACS

Modified shock index - a strong preditor of outcome among patients presenting ST-segment elevation myocardial infarction

Background: Prompt identification of higher risk patients presenting with ST-elevation myocardial infarction (STEMI) and undergoing primary percutaneous coronary intervention will allow a more assertive strategy and approach. Aim: To evaluate the modified shock index (MSI) - a ratio of heart rate (HR) to mean blood pressure (MAP), as a predictor of in hospital and 6-month mortality among patients (pts) admitted with STEMI. Methods: We analyzed retrospectively 2389 pts admitted consecutively in our coronary care unit with acute coronary syndrome, from July of 2009 to June 2014 and we selected those who presented with STEMI (n=1140). They were divided in two groups: group 1 – pts with MSI <1.3, n=1076, 94.4%); group 2 – pts with MSI ≥1.3 (n=64, 5.6%). For each group we compared clinical and laboratory features and adverse events. Primary endpoint was the occurrence of death at 6 months; follow-up was completed in 99% of patients. Results: Patients of group 2 were older (62±14 vs 67±14; p=0.003), more frequent women (19% vs 37.5%; p1 (18.0% vs 56.3%; p<0.001), Killip=4 (2.9% vs 28.1%; p<0.001), anaemia (20.9% vs 48.4%; p<0.001) and renal insufficiency (eGFR<60 ml/min) (21.8% vs 42.6%; p<0,001). They also presented more severe coronary disease - left main coronary artery or 3 vessels disease (16.3% vs 31.3%; p=0.005) and higher prevalence of moderate to severe systolic dysfunction (48.3% vs 68.9%; p=0.009). They required more often aminergic support (7.4% vs 50%; p<0.001), intra-aortic balloon pump (2.9% vs 38.3%; p<0.001) and mechanical ventilation (2.6% vs 17.4%; p<0.001). They also had higher prevalence of malignant arrhythmias (6.1% vs 15.6%; p= 0.008) and mechanical complications (1.7 vs 6.3%; p=0.031). Compared with 1st group, the 2nd group had 6.42 times higher in hospital mortality [OR 6.42; 95% CI (4.07 – 12.67)]; p <0.001] and 7.18 times higher 6-month mortality [OR 7.18; 95% CI (3.30 - 12.46)]; p <0.001]. After adjusting for different baseline characteristics in multivariate analysis, MSI ≥1.3 remained as independent predictor of overall 6-month mortality [OR 3.81, 95% CI (1.81-8.03), p<0.001]. Conclusion: Modified shock index ≥1.3 is a stronger predictor of in hospital and 6 month mortality among patients with STEMI

High-grade atrioventricular block in ST-segment elevation myocardial infarction patients: insights of a terciary centre

Background: High-grade atrioventricular block (HABV) is associated with poorer outcomes in the setting of acute coronary syndromes. Limited information is available on the incidence and death associated with HABV in STEMI patients (pts) receiving contemporary treatment. Aim: To evaluate the incidence of HABV and its impact on outcome of STEMI patients, in primary percutaneous coronary intervention era. Methods: We analysed retrospectively 1149 STEMI pts admitted, consecutively, in our coronary care unit, from July of 2009 to June 2014. They were divided in two groups: group 1 – pts without HABV, n=1057, 92%); group 2 – pts with HABV (n=92, 8%). For each group we compared clinical features and adverse events. Primary endpoint was the occurrence of death at 6 months; follow-up was completed in 99,8% of patients. Results: Patients of group 2 were older (62±13 vs 69±15;p1 (18.0 % vs 42.4%;p1 (71.4% vs 37,2%;p<0.001), left ventricular dysfunction (100% vs 34.8%;p<0.001), but less right ventricular dysfunction (7.1% vs 28.4%;p<0.001). Compared with IMI pts, AMI pts had higher risk of in hospital [OR 9.04, 95% CI (2.87-28.50);p<0.001] and 6-month mortality [OR 10.88; 95% CI (3.33 – 35.53);p<0.001]. After adjusting for different baseline characteristics in multivariate analysis, HABV patients had higher risk of overall 6-month mortality compared to those without HABV [OR 2.18, 95% CI (1.25-3.79),p=0.006]. Conclusion: Besides low incidence of HABV, this complication continues to have a high risk of in-hospital and 6-month mortality and occurring with AMI the risk increases significantly

Temporal trends of risk profile among patients admitted with acute coronary syndrome

Background: Clinical practice focuses on the primary prevention of cardiovascular (CVD) disease through the modification and pharmacological treatment of elevated risk factors, in order to minimize long-term CVD risk. Aim: To determine if there are differences in risk profile of patients admitted with acute coronary syndrome over time. Methods: We analysed 4871 patients admitted consecutively in our coronary care unit with a diagnosis of ACS and included in a prospective registry, from January 2002 to October 2013. Patients were divided in 3 groups of 4 consecutive years: group 1 – from 2002 to 2005 (n=1245, 25.6%); group 2 – from 2006 to 2009 (n=1562, 32%); group 3 - from 2010 to 2013 (n=2064, 42.4%). For each group we studied the prevalence of conventional risk factors (CRF) including diabetes, hypertension, smoking and dyslipidaemia over time and compared findings according to sex and type of acute coronary syndrome: Results: Women were less prevalent in group 3 (26.2% vs 26.9% vs 22.6%, p=0.006). Temporal trends of age and diabetes didn’t show statistic signify. Group 2 and 3 evidenced higher body mass index (26.48±4.0 vs 27.13±5.8 vs 27.15±4.67 kg/m2; p<0.001), had higher prevalence of dyslipidaemia (43.1% vs 49.2% vs 56.3%; p<0.001), smoking (39.4% vs 65.0% vs 64.4%; p<0.001) and hypertension (55.7% vs 65.0% vs 64.4%; p<0.001). We found at least 1 CRF in 92,4% of patients. The first temporal period had higher prevalence of 1 or 2 CRF, on the contrary two thirds of patients in group 3 had 2 or 3 CRF. Over time, hypertension was more prevalent in women (69.3% vs 77,4% vs 78.6%; p=0,007), on the other hand, smoking and dyslipidaemia occurred more often in men. It was observed an increasing tendency of smoking (44% vs 41.6% vs 54%; p100 mg/dl more often (66% vs 57% vs 68.8%; p=0.022), but higher control of systolic blood pressure below 140mmHg (54.2% vs 59.6% vs 65.7%, p<0.001. Conclusion: We found that the risk profile of patients presenting with acute coronary syndrome worsened over the years. In recent time, patients had more CRF, being smoking and hypertension the leaders