Taponamiento cardíaco por hematoma retroauricular

Durante el postoperatorio de sustitución de aorta ascendente con tubo valvulado tipo Hamsfield por disección aórtica tipo A, una paciente presentó hipotensión con oliguria, sin pulso paradójico. Mediante ecografía transesofágica en la unidad de cuidados intensivos se puso de manifiesto un hematoma pericárdico que comprimía la aurícula derecha. Se realizó un drenaje subxifoideo mediante una cánula de aspiración bajo control ecocardiográfico, se aspiró el coágulo y se solucionó el compromiso hemodinámico

Treatment intensification with raltegravir in subjects with sustained HIV―1 viraemia suppression: a randomized 48―week study

Background Residual viraemia is a major obstacle to HIV-1 eradication in subjects receiving HAART. The intensification with raltegravir could impact latent reservoirs and might lead to a reduction of plasma HIV-1 viraemia (viral load [VL]), complementary DNA intermediates and immune activation. Methods This was a prospective, open-label, randomized study comprising 69 individuals on suppressive HAART randomly assigned 2:1 to add raltegravir during 48 weeks. Results Total and integrated HIV-1 DNA, and ultrasensitive VL remained stable despite intensification. There was a significant increase in episomal HIV DNA at weeks 2–4 in the raltegravir group returning to baseline levels at week 48. Median CD4+ T-cell counts increased 124 and 80 cells/μl in the intensified and control groups after 48 weeks ( P=0.005 and P=0.027, respectively), without significant differences between groups. No major changes were observed in activation of CD4+ T-cells. Conversely, raltegravir intensification significantly reduced activation of CD8+ T-cells at week 48 (HLA-DR+CD38+, P=0.005), especially in the memory compartment (CD38+ of CD8+CD45RO+, P&lt;0.0001). Linear mix models also depicted a larger decrease in CD8+ T-cell activation in the intensification group ( P=0.036 and P=0.010, respectively). Raltegravir intensification was not associated to any particular adverse event. Conclusions Intensification of HAART with raltegravir during 48 weeks was safe and associated with a significant decrease in CD8+ T-cell activation, and a transient increase of episomal HIV-1 DNA. However, raltegravir did not significantly contribute to changes in CD4+ T-cell counts, ultrasensitive VL, and total and integrated HIV-1 DNA. These findings suggest that raltegravir impacts residual HIV-1 replication and support new strategies to impair HIV-1 persistence. ClinicalTrials.gov identifier: NCT00554398. </jats:sec

Enraizamento de estacas de Chamaecyparis lawsoniana Parl. em cinco substratos com uso de ácido indolbutírico Rooting of Chamaecyparis lawsoniana Parl. cuttings with indolbutyric acid in five media

Com o objetivo de determinar o melhor substrato disponível na região para o enraizamento de estacas de Chamaecyparis lawsoniana Parl., utilizaram-se os substratos vermiculita fina, casca de arroz carbonizada, areia e as misturas casca de arroz carbonizada + vermiculita fina e areia + vermiculita fina (1:1 v/v). O experimento foi realizado em estufa do Departamento de Fitotecnia da Faculdade de Agronomia Eliseu Maciel/Universidade Federal de Pelotas, no período de maio a setembro de 1997, sob nebulização intermitente. Foram empregadas estacas apicais com 15cm de comprimento, submetidas ao tratamento com ácido indolbutírico (AIB) na concentração de 10.000ppm. Foram efetuadas as seguintes avaliações: número de raízes por estaca, peso da matéria seca das raízes, comprimento da maior raiz por estaca e percentual de estacas enraizadas. Os resultados mostraram que dos substratos testados e com a concentração de AIB utilizada, a vermiculita fina apresentou os melhores resultados, com 99% das estacas enraizadas, maior número raízes por estaca (15), maior comprimento de raiz (12cm) e maior peso da matéria seca das raízes (0,04g).<br>To determine the best medium available in Pelotas, RS, for rooting of Chamaecyparis lawsoniana Parl. cuttings, the media fine vermiculite, carbonized rice hull, sand, carbonized rice hull + fine vermiculite and sand + fine vermiculite (1:1 v/v) were used. This experiment was carried out in a glass greenhouse with intermitent mist at the Plant Science Department of Faculdade de Agronomia Eliseu Maciel/Universidade Federal de Pelotas, from May to September 1997. Apical cuttings 15cm long were treated with indolbutyric acid (IBA) at 10.000ppm. The following evaluations were made: number of roots per cutting, weight of root dry matter, length of the longest root per cutting, and rooted cutting percentage. The results show that the vermiculite medium, with the IBA concentration utilized, is the most suitable for the rooting of C. lawsoniana cuttings, with 99% of rooting, greater number of roots per cutting (15), greater length of roots (12cm) and greater weight of root dry matter (0.04g)