21 research outputs found
The effect of simulated heat-shock and daily temperature fluctuations on seed germination of four species from fire-prone ecosystems
Disturbance as a factor in breaking dormancy and enhancing invasiveness of African grasses in a Neotropical Savanna
EFEITO DE ALTAS TEMPERATURAS NA GERMINAÇÃO DE SEMENTES DE Plathymenia reticulata Benth. E Dalbergia miscolobium Benth.
Anastomose mamária-coronária: análise de 2923 casos Mammary-coronary artery anastomosis: analysis of 2923 cases
Foi a partir de 1972 que, no Instituto Dante Pazzanese de Cardiologia, se iniciou o emprego da anastomose mamária-coronária associada, ou não, a pontes de safena, ou a outros procedimentos. Nessa época, apenas a artéria mamária interna esquerda (AMIE) foi usada (57 casos) para a revascularização da descendente anterior (DA) ou diagonal. No período 1973/1974 (386 casos), já ocorreram as primeiras anastomoses seqüenciais AMIE-DA/DA, assim como a artéria mamária interna direita (AMID) passou a ser empregada para ramos diagonais. Com a finalidade de verificar a evolução tardia desta técnica, sua aplicação foi praticamente interrompida, entre 1975/1982, restringindo-se a apenas 43 casos, nesse período. Entretanto, a partir de 1982 até junho de 1986, ocorreu significativo incremento na sua aplicação (2374 casos), sendo que, desde então, a quase totalidade (93%) das cirurgias de revascularização do miocárdio tem uma ou mais coronárias tratadas com anastomose mamária-coronária. A combinação mais freqüente é AMIE/DA nos casos de mamária isolada e AMIE/DA e AMID/Mg Cx nos casos de dupla mamária. Contudo, observaram-se, na casuística, as mais variadas combinações (71) e associações, abrangendo, praticamente, todas as artérias coronárias. Analisando-se o pós-operatório imediato de um grupo isolado de 177 pacientes operados em 1984, observou-se que esta técnica não influiu na ocorrência de deiscência parcial, ou total, de esterno, em reoperação por sangramento; todavia, ocorreram, em 25% dos casos, elevação transitória da cúpula frénica, atelectasia em 17% e derrame pleural residual em 27,6%, geralmente concomitantes. Em relação à evolução tardia, num grupo de 754 pacientes com mamária e safena e com evolução até 9 anos, em 924 (71,8% dos enxertos reestudados, constataram-se índices de permeabilidade de 91,5% nas mamárias versus 70,6% (826) das pontes de safena. Em outro grupo (102 pacientes), com evolução entre 5 a 10 anos, apenas com mamária isolada, em 55 reestudos constataram-se 94,4% (50) de mamárias permeáveis e 5,6% (3) de ocluidas. A mortalidade intra-hospitalar, nos 2923 casos, foi de 3,45%.At the Instituto Dante Pazzanese de Cardiollogia, the use of mammary-coronary anastomosis was iniciated in 1972, isolated or with saphenous vein by-pass or other procedure. Initially only left internal mammary artery LAD anastomosis was employed in a few (57) cases. In 1973/1974, the aplication of this technique was intensified-386 cases. The method was practically descontinued between 1975 to 1982 - only 43 cases were performed. Since then, its use increased steadily and the right internal mammary artery has been used as well. In 1984, studying 177 patients, we observed that this technique does not influence the incidence of external dehiscence on the reoperation for bleeding; but in 25% occurred an elevation of hemolateral diaphragm, in 17% atelectasis, and in 27.6% pleural effusion. In 654 patients with mammary-coronary anastomoses and saphenous vein grafts followed up to nine years; patency was 91.5% for mammaries and 70.6% for saphenous veins. In another group of 102 patients with isolated mammarycoronary anastomosis patency was 94.4% in a period between 5 and 10 years. The mortality rate of all 2923 cases was 3.45%
Assessing ecosystem services and biodiversity tradeoffs across agricultural landscapes in a mountain region
The HOPE (Heart Outcomes Prevention Evaluation) Study: The design of a large, simple randomized trial of an angiotensin converting enzyme inhibitor (ramipril) and vitamin E in patients at high risk of cardiovascular events
OBJECTIVE: To describe the design of the HOPE (Heart Outcomes Prevention Evaluation) Study.DESIGN: Description of the key design features of HOPE, a large, simple randomized trial of two widely applicable treatments - ramipril, an angiotensin-converting enzyme inhibitor; and vitamin E, a naturally occurring antioxidant vitamin - in the prevention of myocardial infarction, stroke or cardiovascular death.SETTING: Two-hundred and sixty-seven hospitals, physician offices and clinics in Canada, the United States, Mexico, Europe and South America.PATIENTS: Over 9000 women and men aged 55 years and above at high risk for cardiovascular events such as myocardial infarction and stroke were recruited over 18 months.INTERVENTIONS: A 2x2 factorial design with ramipril and vitamin E with follow-up for up to four years.CONCLUSIONS: HOPE will be one of the largest trials of two new interventions to prevent myocardial infarction, stroke or cardiovascular death in high risk patients. The results of HOPE will have direct public health impact and are likely to be readily incorporated into clinical practice. Key design features of HOPE are inclusion of individuals at high risk of cardiovascular disease, inclusion of a substantial proportion of patients with diabetes (36%) and women (27%), and detailed substudies to provide data on mechanisms of benefit