Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluation

Objectives: Refractory angina (RA) is a chronic condition clinically characterized by low effort tolerance; therefore, physical stress testing is not usually requested for these patients. Cardiopulmonary exercise testing (CPET) is considered a gold standard examination for functional capacity evaluation, even in submaximal tests, and it has gained great prominence in detecting ischemia. The authors aimed to determine cardiorespiratory capacity by using the oxygen consumption efficiency slope (OUES) in patients with refractory angina. The authors also studied the O2 pulse response by CPET and the association of ischemic changes with contractile modifications by exercise stress echocardiography (ESE). Methods: Thirty-one patients of both sexes, aged 45 to 75 years, with symptomatic (Canadian Cardiovascular Society class II to IV) angina who underwent CPET on a treadmill and exercise stress echocardiography on a lower limb cycle ergometer were studied. ClinicalTrials.gov: NCT03218891. Results: The patients had low cardiorespiratory capacity (OUES of 1.74 ± 0.4 L/min; 63.9±14.7% of predicted), and 77% of patients had a flattening or drop in O2 pulse response. There was a direct association between Heart Rate (HR) at the onset of myocardial ischemia detected by ESE and HR at the onset of flattening or drop in oxygen pulse response detected by CPET (R = 0.48; p = 0.019). Conclusion: Patients with refractory angina demonstrate low cardiorespiratory capacity. CPET shows good sensitivity for detecting abnormal cardiovascular response in these patients with a significant relationship between flattening O2 pulse response during CEPT and contractile alterations detected by exercise stress echocardiography

Ação do extrato metanólico e etanólico de Davilla elliptica St. Hill. (Malpighiaceae) na resposta imune

Plantas têm contribuído no tratamento da maioria das doenças. Considerando a importância terapêutica das plantas medicinais, foi avaliada a atividade imunológica dos extratos metanólico e etanólico de Davilla elliptica. Macrófagos estão envolvidos em todos estágios da resposta imune, podendo liberar componentes como: peróxido de hidrogênio (H2O2), óxido nítrico (NO) e fator de necrose tumoral-alfa (TNF-alfa). A estimulação dos macrófagos foi avaliada pela determinação de H2O2, NO e TNF-alfa em culturas de macrófagos peritoneais de camundongos na presença dos extratos da D. elliptica. IC50 foi determinado através de ensaio utilizando MTT. Os estudos fitoquímicos realizados mostraram a presença de flavonóides derivados da quercetina e miricetina entre outros compostos. A produção de H2O2 não foi muito expressiva em ambos extratos, contudo a de NO foi significativa. Os dois extratos induziram a produção de TNF-alfa, sendo que a liberação dessa citocina pelo extrato metanólico foi quase cinco vezes maior do que pelo extrato etanólico. Uma relação entre as sínteses de NO e TNF-alfa foi observada. O aumento na produção de NO está relacionado com a indução de citocinas pró-inflamatórias como TNF-alfa. Analisando os resultados, sugere-se que os extratos metanólico e etanólico de D. elliptica podem modular a ativação de macrófagos.Plants have contributed in a significant way to the treatment of most of the diseases. Considering the therapeutic importance of the medicinal plants, the immunological activity of the methanolic and ethanolic extract of Davilla elliptica was evaluated. In every stage of the immune response macrophages are involved and they can release many compounds such as hydrogen peroxide (H2O2), nitric oxide (NO) and tumor necrosis factor-alpha (TNF-alpha). Macrophages stimulation was evaluated by the determination of H2O2, NO and TNF-alpha in peritoneal macrophages cultures of mice in the presence of the D. elliptica extracts. IC50 was determined by MTT assay. The phytochemical study showed flavonoids derived from quercetin and myricetin and other compounds. The production of H2O2 was not very expressive in both extracts, but they presented a significant effect on NO production. The two extracts induced TNF-alpha production, although the methanolic liberated almost five times more TNF-alpha than the ethanolic one. A relationship among the synthesis of NO and TNF-alpha was observed. The increase of NO production is related with the induction of proinflammatory cytokines like TNF-alpha. Analyzing the results, it is suggested that methanolic and ethanolic extract of D. elliptica can modulate macrophage activation.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Conservação refrigerada de carambolas em embalagens plásticas Refrigerated preservation of carambolas in plastic packagings

Pesquisou-se o efeito de duas embalagens (polietileno de baixa densidade - PEBD e polipropileno - Longa Vida Pak ou LVP) em relação ao controle (sem embalagem) sobre a conservação de carambolas em atmosfera refrigerada (10 ºC). Utilizou-se o planejamento fatorial inteiramente casualizado 3 x 4 x 2 (3 embalagens x 4 períodos de armazenamento x 2 repetições). As análises para acompanhamento do armazenamento foram: pH, &ordm;Brix (sólidos solúveis), acidez titulável, perda de peso, coliformes totais e fecais, bolores e leveduras. O nível de contaminação microbiológica (bolores e leveduras) foi aceitável até 21 e 28 dias para carambolas não embaladas e embaladas, respectivamente. A embalagem LVP apresentou os menores índices de contaminação. Em relação às alterações físico-químicas, não houve diferenças significativas entre as embalagens com relação a perda de peso, pH e acidez titulável e o teor de sólidos solúveis foi maior para os frutos armazenados em embalagens LVP. Os resultados globais indicam que ambas as embalagens aumentam a vida útil deste produto e que, do ponto de vista microbiológico, a embalagem LVP foi melhor que a embalagem PEBD para a preservação sob condições refrigeradas.<br>The aim of the study was to investigate the effect of two packaging materials (low density polyethylene- LPDE and polypropylene-LVP) on Averrhoa carambola L shelf-life under refrigeration. A factorial design 3 x 4 x 2 (3 packaging x 4 days of storage x 2 repetitions) was used. The fruits were analysed for pH, total soluble solids, total titrable acidity, weight loss, total and fecal coliforms, moulds and yeasts. The microbiological contamination levels (moulds and yeast) was acceptable up to 21 and 28 storage days for unpacked and packed fruits, respectively. The fruits inside LVP packaging showed lower level of contamination. The weight loss, pH and titrable acidity alterations were not significantly different between the two packagings. The total soluble solids were higher for fruits inside the LVP packaging. These global results indicate that both packagings increased the shelf-life of the product and that from a microbiological standpoint, the LVP packaging was better than the LPDE packaging for preservation under refrigerated conditions