Circulación extracorpórea y complicaciones en el período post-operatorio inmediato de cirugías cardíacas

OBJETIVO: Comparar a frequência de complicações apresentadas pelos pacientes, durante o pós-operatório imediato (POI), de cirurgias cardíacas de acordo com o tempo de circulação extra-corpórea (CEC). MÉTODOS: Estudo de natureza quantitativa, descritivo e correlacional com 83 pacientes adultos divididos em dois grupos de acordo com o tempo de CEC. RESULTADOS: Do total de pacientes, 44 (53%) tiveram o tempo de duração da CEC de até 85 minutos e 39 (47 %) tiveram o tempo acima de 85 minutos. As complicações foram comuns para ambos os grupos, sendo as mais frequentes dor e oligúria. No entanto, hemotórax, pneumotórax e infarto agudo do miocárdio ocorreram apenas no grupo com maior tempo de CEC. CONCLUSÃO: A maioria das complicações ocorridas no POI apresentou frequencia semelhante para os pacientes, independente do tempo de CEC

A alta hospitalar para familiares de pacientes com doença arterial coronariana

Fourteen families of coronary artery disease patients were interviewed to describe their perspectives concerning the cardiac disease and hospital discharge. Ten patients had been hospitalized for clinical treatment, and for surgical treatment. The case study method was selected, and the analysis process resulted in the following categories: the disease as a problem, the heart meaning everything and, their coming back home after hospital discharge. We concluded that the heart is the core of the emotions for the relatives and, when the patients return home, there is a concern about keeping them away from potentially damaging emotions that might trigger a new ischemic event.Con el objetivo de describir las perspectivas de los familiares frente a la alta hospitalaria, fueron entrevistados 14 familiares de pacientes con enfermedad arterial coronariana internados para tratamiento clínico (10 pacientes) o quirúrgico (4). La metodologia fue a de estudio de caso y el proceso de análisis resultó en las categorias: la enfermedad como un problema, el corazón significando todo y el retorno al hogar después de la alta hospitalaria. Las conclusiones fueron que el corazón es el centro de las emociones para los familiares y que en el retorno del enfermo al hogar una de las preocupaciones es la de combatir fuertes emociones que puedan resultar en nuevo evento isquémico.Com o objetivo descrever as perspectivas dos familiares frente à alta hospitalar, foram entrevistados 14 familiares de pacientes com doença arterial coronariana internados para tratamento clínico (10 pacientes) ou cirúrgico (4). A metodologia foi a de estudo de caso e o processo de análise resultou nas categorias: a doença como um problema, o coração significando tudo e a volta para casa após a alta hospitalar. As conclusões foram que o coração é o centro das emoções para os familiares e que na volta do doente para casa, a preocupação é poupá-lo de emoções fortes que possam desencadear novo evento isquêmico

Vascular aging : facts and factors

"Man is as old as his arteries". This old aphorism has been widely confirmed by epidemiological and observational studies establishing that cardiovascular diseases can be age-related in terms of their onset and progression. Besides, with aging come a number of physiological and morphological changes that alters cardiovascular function and lead to subsequently increased risk of cardiovascular disease, even in health asymptomatic individuals. Even though different adaptive mechanisms to protect blood vessels against mild stress have been described, the aging process induces a progressive failure of protective mechanisms, leading to vascular changes. The outcomes of the aging-related modifications are the impairment of homeostasis of the irrigated organs and resultant target organ damage

Late Onset of Estrogen Therapy Impairs Carotid Function of Senescent Females in Association with Altered Prostanoid Balance and Upregulation of the Variant ERα36

Recent analysis of clinical trials on estrogen therapy proposes the existence of a therapeutic window of opportunity for the cardiovascular benefits of estrogens, which depend on women's age and the onset of therapy initiation. In this study, we aimed to determine how vascular senescence and the onset of estrogen treatment influence the common carotid artery (CCA) function in senescent and non-senescent females. Ovariectomized female senescence-accelerated (SAMP8) or non-senescent (SAMR1) mice were treated with vehicle (OVX) or 17β-estradiol starting at the day of ovariectomy (early-onset, E2E) or 45 days after surgery (late-onset, E2L). In SAMR1, both treatments, E2E and E2L, reduced constriction to phenylephrine (Phe) in CCA [(AUC) OVX: 193.8 ± 15.5; E2E: 128.1 ± 11.6; E2L: 130.2 ± 15.8, p = 0.004] in association with positive regulation of NO/O2- ratio and increased prostacyclin production. In contrast, E2E treatment did not modify vasoconstrictor responses to Phe in OVX-SAMP8 and, yet, E2L increased Phe vasoconstriction [(AUC) OVX: 165.3 ± 10; E2E: 183.3 ± 11.1; E2L: 256.3 ± 30.4, p = 0.005]. Increased vasoconstriction in E2L-SAMP8 was associated with augmented thromboxane A2 and reduced NO production. Analysis of wild-type receptor alpha (ERα66) expression and its variants revealed an increased expression of ERα36 in E2L-SAMP8 in correlation with unfavorable effects of estrogen in those animals. In conclusion, estrogen exerts beneficial effects in non-senescent CCA, regardless of the initiation of the therapy. In senescent CCA, however, estrogen loses its beneficial action even when administered shortly after ovariectomy and may become detrimental when given late after ovariectomy. Aging and onset of estrogen treatment are two critical factors in the mechanism of action of this hormone in CCA

PRODUÇÃO LEITEIRA DE BUBALINOS E SUAS PARTICULARIDADES EM COMPARAÇÃO AOS DE BOVINOS

Brazil has the largest herd of buffaloes in the western world, with the Murrah breed predominant, adapting well in various locations. Buffalo milk has peculiarities in relation to bovine milk, being rich in nutrients such as lipids, proteins, lactose, calcium, phosphorus and magnesium. The production of buffalo milk derivatives has been well received in Brazil, due to the capacity for transformation into derivative products and the demand for these products. Buffalo milk is around 40-50% more productive in the production of derivatives such as cheese, yogurt and dulce de leche, compared to bovine milk, due to the higher fat content. The objective of this study is to demonstrate the characteristics between cow's and buffalo's milk, thereby showing the profitability that buffalo milk can generate and highlighting improvements in products, as well as data that can contribute to the development of by-products (derivatives) of the buffalo milk for society. Agribusiness plays a fundamental role in the profitability of buffalo farming, showing that buffalo milk can be a profitable business due to better remuneration for the industry and greater added value of the derivatives.O Brasil tem o maior rebanho de bubalinos do mundo ocidental, sendo a raça Murrah predominante, adaptando-se bem em várias localidades. O leite de búfala apresenta peculiaridades em relação ao leite bovino, sendo rico em nutrientes como lipídeos, proteínas, lactose, cálcio, fósforo e magnésio. A produção de derivados de leite de búfala tem sido bem recebida no Brasil, devido à capacidade de transformação em produtos derivados e à demanda por esses produtos. O leite de búfala é cerca de 40-50% mais produtivo na elaboração de derivados como queijos, iogurte e doce de leite, comparado ao leite bovino, devido ao maior teor de gordura. O objetivo desse estudo é demonstrar as características entre o leite de vaca e de búfala, com isso mostrar a rentabilidade que o leite bubalino pode gerar e evidenciando as melhorias nos produtos, além de dados que podem contribuir para o desenvolvimento de subprodutos (derivados) do leite de búfala para sociedade. O agronegócio desempenha um papel fundamental, sobre a rentabilidade da bubalinocultura, mostrando que o leite de búfala pode ser um negócio lucrativo devido à melhor remuneração pela indústria e maior valor agregado dos derivados

Linking In Vitro Models of Endothelial Dysfunction with Cell Senescence

Disfunció endotelial; Envellliment cel·lularDisfunción endotelial; Envejecimiento celularEndothelial dysfunction; SenescenceEndothelial cell dysfunction is the principal cause of several cardiovascular diseases that are increasing in prevalence, healthcare costs, and mortality. Developing a standardized, representative in vitro model of endothelial cell dysfunction is fundamental to a greater understanding of the pathophysiology, and to aiding the development of novel pharmacological therapies. We subjected human umbilical vein endothelial cells (HUVECs) to different periods of nutrient deprivation or increasing doses of H2O2 to represent starvation or elevated oxidative stress, respectively, to investigate changes in cellular function. Both in vitro cellular models of endothelial cell dysfunction-associated senescence developed in this study, starvation and oxidative stress, were validated by markers of cellular senescence (increase in β-galactosidase activity, and changes in senescence gene markers SIRT1 and P21) and endothelial dysfunction as denoted by reductions in angiogenic and migratory capabilities. HUVECs showed a significant H2O2 concentration-dependent reduction in cell viability (p < 0.0001), and a significant increase in oxidative stress (p < 0.0001). Furthermore, HUVECs subjected to 96 h of starvation, or exposed to concentrations of H2O2 of 400 to 1000 μM resulted in impaired angiogenic and migratory potentials. These models will enable improved physiological studies of endothelial cell dysfunction, and the rapid testing of cellular efficacy and toxicity of future novel therapeutic compounds.This research was funded by Beca de Investigacion Basica en Cardiologia from the Sociedad Española de Cardiologia, Fondo de Investigacion en Salud (grants PI18/00277, PI16/00742, PI19/00264, PI18/00960 and PI15/00553) from the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III–Fondo Europeo de Desarrollo Regional (FEDER), and Spanish Society of Respiratory Medicine (SEPAR) and Catalan Society of Pneumology (SOCAP) grants. FRJT and OTC are the recipients of the Ayudas para la formación de profesorado universitario (FPU19/04925) and Miguel Servet (CP17/00114) grants, respectively, from the Spanish Ministry of Science and Innovation. IDIBAPS belongs to the CERCA Programme, and receives partial funding from the Generalitat de Catalunya. Cofunding was provided by the Fondo Europeo de Desarrollo Regional (FEDER); “Una manera de hacer Europa”

Combined U-Pb and Lu-Hf isotope analyses by laser ablation MC-ICP-MS : methodology and applications

O sistema isotópico Lutécio-Hafnio representa uma das ferramentas mais recentes e poderosas para estudos isotópicos e geocronológicos. Análises combinadas in situ de U-Pb e Lu-Hf sobre zircão pelo LA-MC-ICP-MS permitem caracterizar isotopicamente o magma onde ele cristalizou, fornecendo valiosas informações para estudos de proveniência de sedimento e de evolução crustal. Nesse trabalho descrevemos a sistemática de Lu-Hf pelo LA-MC-ICP-MS implantada no laboratório de Geocronologia da Universidade de Brasília e reportamos os resultados obtidos de repetidas análises de três padrões de zircão: GJ-1 = 0.282022 ± 11 (2SD, n=56), Temora 2 = 0.282693 ± 14 (2SD, n=25) and UQ-Z = 0.282127 ± 33 (2SD, n=11). Foi também caracterizada arazão isotópica 176Hf/177Hf(0.282352 ± 22, 2SD, n=14) de um zircão usado como padrão interno do laboratório. Como aplicação geológica, analisamos dois zircões complexos selecionados a partir de uma amostra de migmatito da Província de Borborema, NE do Brasil. Sobre a base dos dados U-Pb e Lu-Hf foram identificados em ambos os zircões dois eventos de cristalização. Um evento mais antigo de 2.05 Ga nos núcleos herdados, representa um evento magmático Paleoproterozoico bem conhecido na Província Borborema. Um segundo evento de ~ 575 Ma, reconhecido nas bordas, representa um evento magmático-metamórfico Neoproterozóico (Brasiliano). ________________________________________________________________________________________ ABSTRACTThe Lutetium-Hafnium isotopic system represents one of the most innovative and powerful tools for geochronology and isotopic studies. Combined U-Pb and Lu-Hf in situ analyses on zircon by LA-MC-ICP-MS permit to characterize isotopically the host magma from which it crystallized furnishing significant information for sediment provenance and crustal evolution studies. In this paper e describe the Lu-Hf systematic by LA-MC-ICP-MS developed in the laboratory of Geochronology of the University of Brasilia and report the results obtained by repeated analyses of 176Hf/177Hf isotopic ratio of three zircon standards: GJ-1 = 0.282022 ± 11 (n=56), Temora 2 = 0.282693 ± 14 (n=25) and UQZ = 0.282127 ± 33 (n=11). The 176Hf/177Hf ratio (0.282352 ± 22, n=14) of gem quality zircon used as in-house standard have been also characterized. As a geological application, we analyzed two complex zircons selected from a migmatitic rocks from the Borborema Province, NE Brazil. On the basis of U-Pb and Lu-Hf data, two main crystallization events have been identified in both studied zircons. An older event at ca. 2.05 Ga recognized in the inherited cores represents a well-characterized paleoproterozoic magmatic event that affected the whole Borborema Province. A second crystallization event at ~ 575 Ma, recognized at the rims, represents a Neoproterozoic (Brazilian) high grade metamorphic-magmatic event

Anorexia nervosa and Wernicke-Korsakoff syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Wernicke's encephalopathy is an acute, potentially fatal, neuropsychiatric syndrome resulting from thiamine deficiency. The disorder is still greatly under-diagnosed, and failure to promptly identify and adequately treat the condition can lead to death or to the chronic form of the encephalopathy - Korsakoff's syndrome. Wernicke's encephalopathy has traditionally been associated with alcoholism but, in recent years, there has been an increase in the number of clinical settings in which the disorder is observed.</p> <p>Case presentation</p> <p>We report the case of a 45-year-old Caucasian woman who arrived at the emergency room presenting signs of marked malnutrition and mental confusion, ataxic gait and ophthalmoplegia. Main laboratory test findings included low serum magnesium and megaloblastic anemia. Brain magnetic resonance imaging revealed increased T2 signal in the supratentorial paraventricular region, the medial regions of the thalamus and the central and periaqueductal midbrain. The diagnosis of Wernicke's encephalopathy was made at once and immediate reposition of thiamine and magnesium was started. The patient had a long history of recurrent thoughts of being overweight, severe self-imposed diet restrictions and self-induced vomiting. She had also been drinking gin on a daily basis for the last eight years. One day after admittance the acute global confusional state resolved, but she presented severe memory deficits and confabulation. After six months of outpatient follow-up, memory deficits remained unaltered.</p> <p>Conclusion</p> <p>In this case, self-imposed long-lasting nutritional deprivation is thought to be the main cause of thiamine deficiency and subsequent encephalopathy, but adjunct factors, such as magnesium depletion and chronic alcohol misuse, might have played an important role, especially in the development of Korsakoff's syndrome. The co-morbidity between eating disorders and substance abuse disorders has emerged as a significant health issue for women, and the subgroup of patients with anorexia nervosa who also misuse alcohol is probably at a particular risk of developing Wernicke-Korsakoff syndrome. The present case report highlights this relevant issue.</p

An effective all-atom potential for proteins

We describe and test an implicit solvent all-atom potential for simulations of protein folding and aggregation. The potential is developed through studies of structural and thermodynamic properties of 17 peptides with diverse secondary structure. Results obtained using the final form of the potential are presented for all these peptides. The same model, with unchanged parameters, is furthermore applied to a heterodimeric coiled-coil system, a mixed alpha/beta protein and a three-helix-bundle protein, with very good results. The computational efficiency of the potential makes it possible to investigate the free-energy landscape of these 49--67-residue systems with high statistical accuracy, using only modest computational resources by today's standards