Pulmonary Embolism Associated to HIV Infection

A presença de anticorpos antifosfolípidos é frequente em doentes com infecção VIH principalmente em fases avançadas da doença. Apesar da elevada prevalência de anticorpos antifosfolípidos, a sua associação a fenómenos trombóticos é rara, estando apenas descritos alguns casos. Os autores apresentam um caso clínico cuja manifestação inaugural de uma infecção VIH foi um tromboembolismo pulmonar associado á presença de anticoagulante lúpico

Routine Transthoracic Echocardiography in a General Intensive Care Unit: an 18 Month Survey in 704 Patients

The authors analyzed 704 transthoracic echocardiographic (TTE) examinations, performed routinely to all admitted patients to a general 16-bed Intensive Care Unit (ICU) during an 18-month period. Data acquisition and prevalence of abnormalities of cardiac structures and function were assessed, as well as the new, previously unknown severe diagnoses. A TTE was performed within the first 24 h of admission on 704 consecutive patients, with a mean age of 61.5+/-17.5 years, ICU stay of 10.6+/-17.1 days, APACHE II 22.6+/-8.9, and SAPS II 52.7+/-20.4. In four patients, TTE could not be performed. Left ventricular (LV) dimensions were quantified in 689 (97.8%) patients, and LV function in 670 (95.2%) patients. Cardiac output (CO) was determined in 610 (86.7%), and mitral E/A in 399 (85.9% of patients in sinus rhythm). Echocardiographic abnormalities were detected in 234 (33%) patients, the most common being left atrial (LA) enlargement (n=163), and LV dysfunction (n=132). Patients with these alterations were older (66+/-16.5 vs 58.1+/-17.4, p<0.001), presented a higher APACHE II score (24.4+/-8.7 vs 21.1+/-8.9, p<0.001), and had a higher mortality rate (40.1% vs 25.4%, p<0.001). Severe, previously unknown echocardiographic diagnoses were detected in 53 (7.5%) patients; the most frequent condition was severe LV dysfunction. Through a multivariate logistic regression analysis, it was determined that mortality was affected by tricuspid regurgitation (p=0.016, CI 1.007-1.016) and ICU stay (p<0.001, CI 1-1.019). We conclude that TTE can detect most cardiac structures in a general ICU. One-third of the patients studied presented cardiac structural or functional alterations and 7.5% severe previously unknown diagnoses

Aquaporins Are Differentially Regulated in Canine Cryptorchid Efferent Ductules and Epididymis

The efferent ductules and the epididymis are parts of the male reproductive system where spermatozoa mature. Specialized epithelial cells in these ducts contribute to the transport of fluids produced by spermatozoa's metabolic activity. Aquaporins (AQPs) have been demonstrated to be expressed in the spermatozoan membrane and testis epithelial cells, where they contribute to regulating spermatozoan volume and transit through environments of differing osmolality. Due to the lack of detailed literature regarding AQP expression in the canine male genital tract, the aim of this study was to investigate both the distribution and expression of AQP7, AQP8, and AQP9 in the efferent ductules and epididymal regions (caput, corpus, and cauda) from normal and cryptorchid dogs by using immunohistochemistry, Western blotting, and real-time reverse transcription polymerase chain reaction (RT-PCR). Our results show different patterns for the distribution and expression of the examined AQPs, with particular evidence of their upregulation in the caput and downregulation in the cauda region of the canine cryptorchid epididymis. These findings are associated with a modulation of Hsp70 and caspase-3 expression, suggesting the participation of AQPs in the luminal microenvironment modifications that are peculiar characteristics of this pathophysiological condition

Phase Transitions And Spatially Ordered Counterion Association In Ionic-lipid Membranes: A Statistical Model.

We propose a statistical model to account for the gel-fluid anomalous phase transitions in charged bilayer- or lamellae-forming ionic lipids. The model Hamiltonian comprises effective attractive interactions to describe neutral-lipid membranes as well as the effect of electrostatic repulsions of the discrete ionic charges on the lipid headgroups. The latter can be counterion dissociated (charged) or counterion associated (neutral), while the lipid acyl chains may be in gel (low-temperature or high-lateral-pressure) or fluid (high-temperature or low-lateral-pressure) states. The system is modeled as a lattice gas with two distinct particle types--each one associated, respectively, with the polar-headgroup and the acyl-chain states--which can be mapped onto an Ashkin-Teller model with the inclusion of cubic terms. The model displays a rich thermodynamic behavior in terms of the chemical potential of counterions (related to added salt concentration) and lateral pressure. In particular, we show the existence of semidissociated thermodynamic phases related to the onset of charge order in the system. This type of order stems from spatially ordered counterion association to the lipid headgroups, in which charged and neutral lipids alternate in a checkerboard-like order. Within the mean-field approximation, we predict that the acyl-chain order-disorder transition is discontinuous, with the first-order line ending at a critical point, as in the neutral case. Moreover, the charge order gives rise to continuous transitions, with the associated second-order lines joining the aforementioned first-order line at critical end points. We explore the thermodynamic behavior of some physical quantities, like the specific heat at constant lateral pressure and the degree of ionization, associated with the fraction of charged lipid headgroups.8403190

Autoimmunity Overlaps Primary Biliary Cirrhosis: a Not Straightforward Diagnosis

info:eu-repo/semantics/publishedVersio

Monte Carlo simulation of uncoupled continuous-time random walks yielding a stochastic solution of the space-time fractional diffusion equation

We present a numerical method for the Monte Carlo simulation of uncoupled continuous-time random walks with a Levy alpha-stable distribution of jumps in space and a Mittag-Leffler distribution of waiting times, and apply it to the stochastic solution of the Cauchy problem for a partial differential equation with fractional derivatives both in space and in time. The one-parameter Mittag-Leffler function is the natural survival probability leading to time-fractional diffusion equations. Transformation methods for Mittag-Leffler random variables were found later than the well-known transformation method by Chambers, Mallows, and Stuck for Levy alpha-stable random variables and so far have not received as much attention; nor have they been used together with the latter in spite of their mathematical relationship due to the geometric stability of the Mittag-Leffler distribution. Combining the two methods, we obtain an accurate approximation of space- and time-fractional diffusion processes almost as easy and fast to compute as for standard diffusion processes.Comment: 7 pages, 5 figures, 1 table. Presented at the Conference on Computing in Economics and Finance in Montreal, 14-16 June 2007; at the conference "Modelling anomalous diffusion and relaxation" in Jerusalem, 23-28 March 2008; et

Parâmetros Hemodinâmicos Obtidos por Ecocardiografia Transtorácica e Cateterismo da Artéria Pulmonar. Estudo Comparativo em Doentes Submetidos a Transplante Hepático

Objectivo: estudo comparativo simultâneo de medições invasivas utilizando o cateterismo da artéria pulmonar e não invasivas utilizando a ecocardiografia transtorácica (ETT) de 4 parâmetros hemodinâmicos: débito cardíaco (DC), pressão de encravamento da artéria pulmonar (PCP), pressão venosa central (PVC), e pressão sistólica da artéria pulmonar (PSAP). Material e Métodos: estudo prospectivo numa Unidade de Cuidados Intensivos (UCI) médico-cirurgica. Foram estudados 41 doentes em pós-operatório de transplante hepático, nos quais o DC, a PCP, a PVC e a PSAP foram obtidos em simultâneo por 2 observadores independentes, utilizando a ETT e o cateterismo invasivo da artéria pulmonar. Para a quantificação por ETT dos parâmetros foram utilizadas fórmulas descritas na literatura. As medições invasivas e não invasivas foram comparadas através de uma análise de correlação linear e de Bland-Altman. Resultados: Verificou-se uma boa correlação nas medições invasivas e não invasivas do DC (r=0,97) e PVC (r=0,88). As correlações entre as medições invasivas e não invasivas da PCP e da PSAP foram fracas (r=0,41 e r= 0,118 respectivamente). O intervalo de confiança de 95% e bias para o DC foi negligenciável, em especial para valores de DC abaixo dos 6l/minuto. A ETT subestima em regra o DC, mas as duas técnicas mostraram uma correlação significativa entre si. Conclusões: a ETT pode estimar de forma fidedigna o DC em doentes submetidos a transplante hepático. A determinação não invasiva das restantes variáveis hemodinâmicas por ETT pode estar sujeita a uma variabilidade grande relacionada com as características dos doentes. Apesar dos dados terem sido obtidos num grupo específico de doentes, podem ajudar a definir uma aplicação futura da ecocardiografia em Cuidados Intensivos

Unconventional carrier-mediated ferromagnetism above room temperature in ion-implanted (Ga, Mn)P:C

Ion implantation of Mn ions into hole-doped GaP has been used to induce ferromagnetic behavior above room temperature for optimized Mn concentrations near 3 at.%. The magnetism is suppressed when the Mn dose is increased or decreased away from the 3 at.% value, or when n-type GaP substrates are used. At low temperatures the saturated moment is on the order of one Bohr magneton, and the spin wave stiffness inferred from the Bloch-law T^3/2 dependence of the magnetization provides an estimate Tc = 385K of the Curie temperature that exceeds the experimental value, Tc = 270K. The presence of ferromagnetic clusters and hysteresis to temperatures of at least 330K is attributed to disorder and proximity to a metal-insulating transition.Comment: 4 pages, 4 figures (RevTex4