High-output heart failure in a newborn.

High-output cardiac failure is rare in newborns. Emergent diagnosis and management of this pathology is crucial. We report the case of a child, currently 12-months old; obstetric background is non-contributory. Clinic observation on D1 was normal except for the presence of a systolic cardiac murmur; cardiological evaluation revealed mild ventricular dysfunction of the right ventricle. On the third day of life, she developed cardiac failure with gallop rhythm, hepatomegaly and a murmur in the anterior fontanel; an echocardiogram confirmed clinic aggravation with biventricular dysfunction and right cavities and superior vena cava dilatation. The cranial MRI confirmed the presence of a pial arteriovenous malformation (AVM) involving the anterior and middle cerebral arteries with an associated fronto-parietal ischaemic lesion. The infant underwent embolisations of AVM with successful flow reduction and cardiac failure improvement. The multidisciplinary follow-up showed no cardiac dysfunction or permanent lesions but confirmed a severe psycho-motor delay and left hemiparesiainfo:eu-repo/semantics/publishedVersio

A Case Study

Funding Information: Inês A. Ferreira acknowledges the financial support from Fundação para a Ciência e Tecnologia (FCT) for funding PhD Grant-REF: SFRH/BD/145448/2019. Helena Carvalho acknowledges Fundação para a Ciência e Tecnologia (FCT) for its financial support through the project UIDB/00667/2020 (UNIDEMI). Carina Pimentel acknowledges Fundação para a Ciência e Tecnologia (FCT) within the R&D Units Project Scope UIDB/00319/2020. Publisher Copyright: © 2023 by the authors.The number of variants of the vehicle routing problem (VRP) has grown rapidly in the last decades. Among these, VRPs with time window constraints are among the most studied ones. However, the literature regarding VRPs that concerns the delivery and installation of products is scarce. The main aim of this study was to propose a heuristic approach for the route planning process of a company whose focus is on furniture delivery and assembly and, thus, contributing to the research around the Delivery and Installation Routing Problem. The case study method was used, and two scenarios were compared: the current scenario (showing the routes created by the company worker); and the future scenario (representing the routes created by the heuristic). Results show that the proposed heuristic approach provided a feasible solution to the problem, allowing it to affect customers and teams without compromising the teams’ competencies and respecting all constraints.publishersversionpublishe

Conteúdos de NPK em biomassa de espécies de azolla cultivadas em várzea do Rio Guamá, em Belém, PA.

bitstream/item/42897/1/Boletim-Pesquisa-166-CPATU.pd

ABO-Incompatible Liver Transplantation in Acute Liver Failure: A Single Portuguese Center Study

INTRODUCTION: ABO-incompatible liver transplantation (ABOi LT) is considered to be a rescue option in emergency transplantation. Herein, we have reported our experience with ABOi LT including long-term survival and major complications in these situations. PATIENT AND METHODS: ABOi LT was performed in cases of severe hepatic failure with imminent death. The standard immunosuppression consisted of basiliximab, corticosteroids, tacrolimus, and mycophenolate mofetil. Pretransplantation patients with anti-ABO titers above 16 underwent plasmapheresis. If the titer was above 128, intravenous immunoglobulin (IVIG) was added at the end of plasmapheresis. The therapeutic approach was based on the clinical situation, hepatic function, and titer evolution. A rapid increase in titer required five consecutive plasmapheresis sessions followed by administration of IVIG, and at the end of the fifth session, rituximab. RESULTS: From January 2009 to July 2012, 10 patients, including 4 men and 6 women of mean age 47.8 years (range, 29 to 64 years), underwent ABOi LT. At a mean follow-up of 19.6 months (range, 2 days to 39 months), 5 patients are alive including 4 with their original grafts. One patient was retransplanted at 9 months. Major complications were infections, which were responsible for 3 deaths due to multiorgan septic failure (2 during the first month); rejection episodes (4 biopsy-proven of humoral rejections in 3 patients and 1 cellular rejection) and biliary. CONCLUSION: The use of ABOi LT as a life-saving procedure is justifiable in emergencies when no other donor is available. With careful recipient selection close monitoring of hemagglutinins and specific immunosuppression we have obtained acceptable outcomes

Contribution of HFE and HPSE genes and methaemoglobin reductase activity to heart failure

Introduction: Heart failure can be defined as a syndrome caused by a structural anomaly and/or by a committed cardiac function, which leads to an inadequate cardiac output unable to meet the metabolic necessities of the organism. We aim to understand if HFE and HPSE genes as well as methaemoglobin reductase activity, may influence the development of heart failure. Methodology: It was performed a case-control study, in which 252 DNA samples from Portuguese individuals were analysed, 143 derived from subjects with heart failure, and 109 from healthy controls. For HPSE genotyping (rs4693608), we performed endpoint PCR analysis. A multiplex ARMS (Amplification-Refractory Mutation System) assay was used for the simultaneous detection of two HFE polymorphisms (C282Y and H63D). Reductase methaemoglobin activity was determined by spectrophotometric methods. All statistical tests were performed with IBM® SPSS® Statistics 26.0 software. Statistical significance was defined as a p-value < 0.05. Results: Regarding the H63D polymorphism, results show the CG genotype as a risk factor [OR (95% CI) = 2.889 (1.041-8.018); p=0.042]. In what concerns HPSE gene, the GG genotype was found to have a protective effect [OR (95% CI) = 0.435 (0.193-0.982); p=0.045] while the presence of the A allele is a risk factor [OR (95% CI) = 2.297 (1.018-5.179); p=0.045. Considering methaemoglobin reductase, its activity was lower in patients than in healthy controls (p=0.019). Discussion: Intravenous iron supplementation is sometimes considered in heart failure treatment, emphasizing the results presented in the present study. Considering the high prevalence of heart failure in Portugal (400.000 individuals, according to Sociedade Portuguesa de Cardiologia), it is important to identify iron-related markers, since it may allow an earlier and more expert approach, which may provide better prevention and therapeutic strategies for this pathology.N/

Study of the interaction between modulators of iron homeostasis and the ACE gene in heart failure

Introduction: Heart failure (HF) refers to a clinical syndrome composed of a set of symptoms and/or signs that originate from a structural and/or functional cardiac anomaly and that give rise to the inability to pump blood in sufficient quantity, to meet the body's metabolic needs. In the present work, we intend to understand how the interaction between the I/D variation in the ACE gene and possible modulators of iron (Fe) homeostasis influence HF. The modulators under study were: the methemoglobin reductase activity, the Hfe gene and heparanase genes (HPSE) Methodology: A case-control study was carried out with 252 Portuguese people, 143 with HF and 109 healthy controls. To analyze the polymorphism in the HPSE gene (rs4693608) endpoint genotyping (LightCycler480) was performed. To analyze both polymorphisms in the Hfe gene (H63D and C282Y), ARMS Multiplex technique was used. For the analysis of the polymorphism in the ECA gene (rs4646994 - I/D) a regular PCR was performed. Methaemoglobin reductase activity was obtained using spectrophotometric assay. All necessary statistical tests were performed using the IBM® SPSS® Statistics 26.0 software, with values considered significant for p < 0.05. Results: There was an association between HF and: 1) the presence of the D allele of the HFe gene (HH vs HD; p=0.049); 2) the presence of the A allele of the HPSE gene (AA + GA vs GG; p=0.045; 3) lower levels of methemoglobin reductase activity (p=0.019). It was also found that epistasis between the presence of the H or C allele of the Hfe gene and the D allele of the ACE gene are protective in HF (p=0.041 for both). Conclusion: Results of this study highlight the role of iron homeostasis and its interaction with ACE in HF. Iron is an essential component for the proper functioning of mitochondria, which play an important role in providing energy to the heart muscle. Knowledge of the genotype profile of patients, in modulating genes of iron homeostasis in interaction with the ACE gene could be an advantage in the application of a more personalized medicine, allowing preventive counseling and more targeted therapy.info:eu-repo/semantics/publishedVersio

Seletividade de herbicidas pré e pós-emergentes para o pinhão-manso.

O experimento foi instalado em Prudente de Morais, MG, em 2009, com o objetivo de avaliar a seletividade de herbicidas aplicados em pré e pós-emergência para a cultura do pinhão manso. ° trabalho foi conduzido em casa de vegetação, em delineamento em blocos ao acaso com 11 tratamentos e três repetições. Os tratamentos foram constituídos por dez herbicidas, sendo quatro pré-emergentes e seis pós-emergentes e uma testemunha que recebeu apenas água no dia da aplicação dos produtos. Os tratamentos, com as doses em 9 ha-1 de La., foram: s-metolachlor (3.100 g), metribuzin (840 g), oxyfluorfen (1.200 g), trifluralin (2.250 g), bentazon (1.350 g), clethodim (102 g), fenoxaprop-p-ethyl (130,42 g), fluazifop-p-butyl (210 g), sethoxydim (253 g) e tepraloxidim (93,5 g). Os herbicidas foram aplicados utilizando-se um pulverizador pressurizado a CO2, equipado com bico tipo leque Magno 110.03, pressão de 2,75 kgf cm-2, com consumo de calda de 210 L ha-1. Foram avaliados os efeitos fitotóxicos do produto, altura das plantas, diâmetro do caule, número de folhas e a biomassa seca da parte aérea e raizes das plantas colhidas aos 50 dias após a aplicação dos produtos. Os herbicidas que apresentaram maior toxicidade às plantas de pinhão manso foram o metribuzin e o bentazon, comprometendo o desenvolvimento da cultura. Os herbicidas s-metolachlor, oxyfluorfen, trifluralin, fenoxaprop-p-ethyl, fluazifop-p-butyl, sethoxydim e tepraloxidim mostraram-se seletivos e foram selecionados para estudos posteriores que contemplem a produção de frutos de pinhão-manso. Esses produtos poderão vir a ser utilizados em um programa de manejo integrado de plantas daninhas em pinhão-manso, pois não existem no Brasil herbicidas seletivos recomendados e disponíveis para essa cultura

Seletividade de herbicidas na cultura do girassol.

O experimento foi instalado em Prudente de Morais, MG, em 2010, com o objetivo de avaliar a seletividade de herbicidas aplicados em pré e pós-emergência na cultura do girassol. O trabalho foi conduzido em casa de vegetação, em delineamento em blocos ao acaso com 11 tratamentos e três repetições. Os tratamentos foram constituídos por dez herbicidas, sendo quatro pré-emergentes e seis pós-emergentes e uma testemunha que recebeu apenas água no dia da aplicação dos produtos. Os tratamentos, com as doses em 9 ha-1 de La., foram: alachlor (3.120 g), imazaquin (187,5 g), metribuzin (1.080 g), trifluralin (2.250 g), chlorimuron-ethyl, (18,75 g), fenoxaprop-p-ethyl (131 g), [fluazifop-p + fomesafen) (220 9 + 275 g), imazapyr (625 g), imazethapyr (175 g) e sethoxydim (253 g). Os herbicidas foram aplicados utilizando-se um pulverizador pressurizado a CO2, equipado com bico tipo leque Magno 110.03, pressão de 2,75 kgf cm-2, com consumo de calda de 210 L ha-1. Foram avaliados os efeitos fitotóxicos do produto, altura das plantas, número de folhas e a biomassa seca da parte aérea e raízes das plantas colhidas aos 60 dias após a aplicação dos produtos. Os herbicidas que apresentaram maior toxicidade ao girassol foram: imazaquin, metribuzin, chlorimuron-ethyl, [fluazifop-p + fomesafen), imazapyr e imazethapyr, que causaram morte total das plantas e/ou redução drástica na biomassa seca. Os herbicidas alachlor, trifluralin, fenoxaprop-p-ethyl e sethoxydim mostraram-se seletivos e foram selecionados para estudos posteriores que contemplem a produção de aquênios de girassol. O fenoxaprop-p-ethyl poderá vir a ser utilizado em um programa de manejo integrado de plantas daninhas em girassol, pois apenas o trifluralin, o alachlor e o sethoxidim são herbicidas registrados para esta cultura