Neonatal pneumomediastinum and the spinnaker-sail sign

A male infant was born at 40 weeks of gestation by vacuum-assisted vaginal delivery. Mild respiratory distress with expiratory grunting and subcostal retraction was noted 1 hour after birth. Arterial oxygen saturation remained at more than 95% without the administration of supplemental oxygen. Chest radiography performed 6 hours after birth (Panel A) showed the spinnaker-sail sign, consisting of a large, wedge-shaped opacity extending from the right hemidiaphragm to the superior mediastinum (white arrows), representing thymic tissue displaced from its usual location by a collection of gas under pressure (black arrows). Axial computed tomography of the chest revealed air trapped between the pericardial sac and the thymus, confirming a diagnosis of anterior pneumomediastinum (Panel B, arrow). Named for its visual resemblance to the headsail of a boat, the spinnaker-sail sign occurs with a spontaneous anterior pneumomediastinum and usually resolves without specific treatment. After being observed for clinical and radiographic improvement for 3 weeks, the infant was discharged home in good condition

Soil quality under different uses and native Cerrado

O uso sustentável do solo tem-se constituído em tema de crescente relevância, em face do aumento das atividades antrópicas. Com o objetivo de avaliar a qualidade do solo em área de Cerrado nativo e em áreas sob diferentes usos, foram amostradas camadas de Latossolo Vermelho-Amarelo sob quatro tipos de ocupação: pastagem natural, pastagem cultivada, cultivo convencional com culturas anuais e florestamento de pínus. As áreas estão localizadas na Fazenda Água Limpa, DF. Foram avaliados os seguintes atributos de qualidade do solo: densidade do solo, resistência mecânica à penetração, taxa de infiltração de água, teor de matéria orgânica, capacidade de troca catiônica, C total da biomassa microbiana e respiração basal. Com base nos dados obtidos, foi organizado um diagrama comparativo e calculado um índice da qualidade do solo para cada tipo de uso. Os resultados evidenciaram relação estreita e inversa entre a qualidade do solo e a intensidade de uso a que as áreas foram submetidas. Mediante análise desses atributos e da elaboração de um modelo comparativo, foi possível avaliar o nível de degradação do solo em função do uso de cada área.Sustainable soil use is becoming increasingly relevant given the increase of anthropic activities. In order to evaluate the soil quality, soil samples were collected from five areas: natural Cerrado (reference), native pasture, planted pasture, annual crops under conventional tillage and pine forest. The areas are located in the Federal District, Brazil, in a clayey Red Yellow Latosol (Acrustox). The following soil quality attributes were measured: bulk density, mechanical resistance to penetration, water infiltration rate, organic matter content, cation exchange capacity, carbon of microbial biomass and basal respiration. Based on the obtained data a comparative diagram was drawn and a soil quality index calculated for each type of use. The results showed a close inverse relationship between soil quality and intensity of use to which the areas were submitted. By analyzing these attributes and the establishment of a comparative model it was possible to evaluate the level of soil degradation caused by each type of use in each area

Avaliação e reforço sísmico de estruturas de betão armado

Apresenta-se um programa experimental que incluiu o ensaio em escala real de dois pórticos de betão armado representativos da construção no sul da Europa com 40/50 anos, com necessi-dade de reabilitação sísmica. São feitas algumas considerações sobre o comportamento experi-mental das estruturas, que foram ensaiadas sem qualquer intervenção, posteriormente reparadas e novamente ensaiadas considerando diferentes técnicas de reforço sísmico

Distinct load dependence of relaxation rate and diastolic function in Oryctolagus cuniculus and Ratus norvegicus

This study investigated potential differences on load dependence of relaxation rate and diastolic function between Oryctolagus cuniculus and Ratus norvegicus, which have constitutive differences in the mechanisms involved in myocardial inactivation. Load dependence of relaxation rate and diastolic function were evaluated with the response of left ventricular time constant tau and diastolic pressure-dimension relation to beat-to-beat aortic constrictions in open-chest rabbits and rats. Afterload levels were normalized, being expressed as a percentage of peak isovolumetric pressure (relative load). In control heartbeats, relaxation rate and diastolic function were similar in the two animal species. They presented, however, distinct responses to afterload elevations. In rabbits, time constant decreased similar to7% and diastolic pressure-dimension relation remained unchanged when afterload was elevated to a relative load of 73-76%. Above this afterload level, a significant deceleration of relaxation rate (increase of time constant) and an upward shift of diastolic pressure-dimension relation were observed. In rats, afterload elevations accelerated pressure fall up to a relative load of 97-100% and no afterload-induced shift of the diastolic pressure-dimension relation was observed. This study provides, therefore, evidence that Oryctolagus cuniculus has lower afterload reserve of myocardial relaxation and diastolic function than Ratus norvegicus

Pattern of right ventricular pressure fall and its modulation by afterload

Pattern of right ventricular pressure (RVP) fall and its afterload dependence were examined by analyzing ventricular pressure curves and corresponding pressure-dP/dt phase planes obtained in both ventricles in the rat heart in situ. Time and value of dP/dt(min), and the time constant tau were measured at baseline and during variable RV afterload elevations, induced by beat-to-beat pulmonary trunk constrictions. RVP and left ventricular pressure (LVP) decays were divided into initial accelerative and subsequent decelerative phases separated by corresponding dP/dt(min). At baseline, LVP fall was decelerative during 4/5 of its course, whereas only 1/3 of RVP decay occurred in a decelerative fashion. During RV afterload elevations, the absolute value of RV-dP/dt(min) and RV-tau increased, whilst time to RV-dP/dt(min) decreased. Concomitantly, the proportion of RVP decay following a decelerative course increased, so that in highly RV afterloaded heartbeats RVP fall became more similar to LVP fall. In conclusion, RVP and LVP decline have distinct patterns, their major portion being decelerative in the LV and accelerative in the RV. In the RV, dP/dt(min), tau and the proportional contribution of accelerative and decelerative phases for ventricular pressure fall are afterload-dependent. Consequently, tau evaluates a relatively much shorter segment of RVP than LVP fall

Octreotide for conservative management of postoperative chylothorax in the neonate

Chylothorax is a possible complication after thoracotomy. Treatment is initially conservative and includes drainage and correction of nutritional losses. Surgical treatment is reserved for cases not responsive to medical measures. The authors report on the clinical case of a premature neonate with a traumatic chylothorax secondary to esophageal atresia surgical correction. The use of octreotide allowed the resolution of the effusion without adverse effects and avoided the surgical treatment

Differential right and left ventricular diastolic tolerance to acute afterload and NCX gene expression in Wistar rats

This study evaluated right ventricular (RV) and left ventricular (LV) diastolic tolerance to afterload and SERCA2a, phospholamban and sodium-calcium exchanger (NCX) gene expression in Wistar rats. Time constant tau and end-diastolic pressure-dimension relation (EDPDR) were analyzed in response to progressive RV or LV afterload elevations, induced by beat-to-beat pulmonary trunk or aortic root constrictions, respectively. Afterload elevations decreased LV-tau, but increased RV-tau. Whereas LV-tau analyzed the major course of pressure fall, RV-tau only assessed the last fourth. Furthermore, RV afterload elevations progressively upward shifted RV-EDPDR, whilst LV afterload elevations did not change LV-EDPDR. SERCA2a and phospholamban mRNA were similar in both ventricles. NCX-mRNA was almost 50% lower in RV than in LV. Left ventricular afterload elevations, therefore, accelerated the pressure fall and did not induce diastolic dysfunction, indicating high LV diastolic tolerance to afterload. On the contrary, RV afterload elevations decelerated the late RV pressure fall and induced diastolic dysfunction, indicating small RV diastolic tolerance to afterload. These results support previous findings relating NCX with late Ca2+ reuptake, late relaxation and diastolic dysfunction

Differential right and left ventricular diastolic tolerance to acute afterload and NCX gene expression in Wistar rats

This study evaluated right ventricular (RV) and left ventricular (LV) diastolic tolerance to afterload and SERCA2a, phospholamban and sodium-calcium exchanger (NCX) gene expression in Wistar rats. Time constant tau and end-diastolic pressure-dimension relation (EDPDR) were analyzed in response to progressive RV or LV afterload elevations, induced by beat-to-beat pulmonary trunk or aortic root constrictions, respectively. Afterload elevations decreased LV-tau, but increased RV-tau. Whereas LV-tau analyzed the major course of pressure fall, RV-tau only assessed the last fourth. Furthermore, RV afterload elevations progressively upward shifted RV-EDPDR, whilst LV afterload elevations did not change LV-EDPDR. SERCA2a and phospholamban mRNA were similar in both ventricles. NCX-mRNA was almost 50% lower in RV than in LV. Left ventricular afterload elevations, therefore, accelerated the pressure fall and did not induce diastolic dysfunction, indicating high LV diastolic tolerance to afterload. On the contrary, RV afterload elevations decelerated the late RV pressure fall and induced diastolic dysfunction, indicating small RV diastolic tolerance to afterload. These results support previous findings relating NCX with late Ca2+ reuptake, late relaxation and diastolic dysfunction

Manejo da fertirrigação em fruteiras e hortaliças.

Necessidade de nutrientes; Frequência de aplicação e distribuição de nutrientes; Preparo e aplicação da solução nutritiva; Monitoramento da fertirrigação