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Natural fibers show an increasing potential as reinforcement of polymeric composites, representing a promising concurrent to glass and carbon fibers extensively used in the construction of wind turbine blades synthetic fibers recyclability/disposability and high production energy cost have already been discussed in the main turbine producing centres. In particular, the development of wind turbines for low wind speed areas can increase the energy generation potential of regions not originally eligible for the installation of large turbines. This study proposes the evaluation of the use of jute fiber (Corchorus capsularis) reinforced epoxy composite in the construction of S1210 airfoil profile, of a small-scale wind turbine for low wind speed regions, considering the structural parameters, developed incorporating the Classical Laminate Theory (CLT) and Extended Bredt-Batho Shear Flow Theory (EBSFT).In order to raise the elastic properties and enable the use of the failure criteria, the composite blades were characterized according to ASTM standards. The mechanical properties surveyed, together with the elastic parameters of the cross section, torsional stiffness, axial stiffness, GJ 1873.6 N m2, EI 9.47 × 104 N m2, and flexural rigidity, Ely 4.97 × 104 N m2, Elz 1.45 × 106 N m2, respectively, demonstrated the feasibility of using the jute fiber reinforced epoxy composite in the blade construction, evaluated according to the maximum tension failure criterion.

Phenylketonuria (PKU) is a genetic disorder caused by deficiency of the enzyme phenylalanine hydroxylase (PAH), which results in phenylalanine (Phe) accumulation in the blood and brain, and requires lifelong treatment to keep blood Phe in a safe range. Pegvaliase is an enzyme-substitution therapy approved for individuals with PKU and uncontrolled blood Phe concentrations (>600 μmol/L) despite prior management. Aggregated results from the PRISM clinical trials demonstrated substantial and sustained reductions in blood Phe with a manageable safety profile, but also noted individual variation in time to and dose needed for a first response. This analysis reports longer-term aggregate findings and characterizes individual participant responses to pegvaliase using final data from the randomized trials PRISM-1 (NCT01819727) and PRISM-2 (NCT01889862), and the open-label extension study 165–304 (NCT03694353). In 261 adult participants with a mean of 36.6 months of pegvaliase treatment, 71.3%, 65.1%, and 59.4% achieved clinically significant blood Phe levels of ≤600, ≤360, and ≤ 120 μmol/L, respectively. Some participants achieved blood Phe reductions with

Objetivo: Conocer la asociación de hallazgos del ultrasonido abdominal en recién nacidos pretérmino con enterocolitis necrosante (ECN). Método: Estudio transversal, analítico, pacientes con ECN. Se realizó ultrasonido abdominal: líquido libre, pared intestino grueso más de 2.5 mm, pared intestino delgado menos de 1.1 mm, gas en vena porta, neumatosis intestinal, disminución y/o ausencia de peristalsis, aumento y/o ausencia de perfusión sanguínea intestinal. Se utilizó chi cuadrada, U de Mann-Whitney para asociación hallazgos ecográficos y ECN, alfa < 0.05, programa SPSS v.23. Resultados: 37 pacientes. Estadio IA: pared de intestino delgado menor de 1.1 mm fueron 15 (40%) pacientes, líquido libre 13 (35%), peristalsis disminuida 11 (29%), ausencia de peristalsis en algunas zonas 8 (21%). Estadio IB: líquido libre y perfusión sanguínea aumentada 2 (5%). Estadio IIA: peristalsis disminuida 7 (18%), pared de intestino delgado menor de 1.1 mm 4(10%), líquido libre 3(8.%), neumatosis 2 (5%), perfusión sanguínea ausente 1 (2%). Estadio IIIA: 1(2%) líquido libre, adelgazamiento de pared de intestino delgado menor de 1.1 mm, ausencia de peristalsis, perfusión sanguínea ausente. Conclusión: Existe asociación de los hallazgos ultrasonográficos en pacientes con ECN. El más frecuente fue adelgazamiento de la pared intestinal de intestino delgado, líquido libre y peristalsis disminuida, sería útil como método diagnóstico para toma de decisiones médico quirúrgico.

Abstract Sugarcane (Saccharum officinarum, Poaceae) is cultivated on a large scale in (sub)tropical regions such as Brazil and has considerable economic value for sugar and biofuel production. The plant is a rich substrate for endo- and epiphytic fungi. Black yeasts in the family Herpotrichiellaceae (Chaetothyriales) are colonizers of human-dominated habitats, particularly those rich in toxins and hydrocarbon pollutants, and may cause severe infections in susceptible human hosts. The present study assessed the diversity of Herpotrichiellaceae associated with sugarcane, using in silico identification and selective isolation. Using metagenomics, we identified 5833 fungal sequences, while 639 black yeast-like isolates were recovered in vitro. In both strategies, the latter fungi were identified as members of the genera Cladophialophora, Exophiala, and Rhinocladiella (Herpotrichiellaceae), Cyphellophora (Cyphellophoraceae), and Knufia (Trichomeriaceae). In addition, we discovered new species of Cladophialophora and Exophiala from sugarcane and its rhizosphere. The first environmental isolation of Cladophialophora bantiana is particularly noteworthy, because this species up to now is exclusively known from the human host where it mostly causes fatal brain disease in otherwise healthy patients.

The hybridisation of fibre-reinforced polymers (FRPs), particularly with the combination of natural and synthetic fibres, is a prominent option for their development. In the context of the construction industry, there is a notable gap in research on the use of jute and glass fibres for the strengthening of concrete structures. This paper presents comprehensive experimental results from tests on seven reinforced concrete (RC) beams strengthened for shear using synthetic, natural, and hybrid jute–glass FRP composites. The beams were reinforced using the externally bonded reinforcement (EBR) technique with U-wrap bonding. A beam without any strengthening was tested and set as a reference for the other beams. Two beams were tested with synthetic FRP shear strengthenings, one with carbon fibre-reinforced polymer (CFRP) and another with glass fibre-reinforced polymer (GFRP). The remaining tests were on RC beams strengthened with natural jute fibre-reinforced polymer (JFRP) and hybrid jute–glass FRP. The paper discusses the experimental behaviour of the tested beams in terms of vertical displacements, crack widths, and strains on steel bars, concrete, and FRP. The experimental strengths are also compared with theoretical estimates obtained using ACI 440.2R and fib Bulletin 90. The tests confirm the effectiveness of natural jute FRP and jute–glass hybrid FRP as an option for the shear strengthening of reinforced concrete beams.

Fomitiporia species have aroused the interest of numerous investigations that reveal their biological activity and medicinal potential. The present investigation shows the antioxidant, anticancer, and immunomodulatory activity of acidic polysaccharides obtained from the fungus Fomitiporia chilensis. The acidic polysaccharides were obtained for acidic precipitation with 2% O-N-cetylpyridinium bromide. Chemical analysis was performed using FT-IR and GC-MS methods. The antioxidant capacity of acidic polysaccharides from F. chilensis was evaluated by scavenging free radicals with an ABTS assay. Macrophage proliferation and cytokine production assays were used to determine the immunomodulatory capacity of the polysaccharides. Anti-tumor and cytotoxicity activity was evaluated with an MTT assay in the U-937, HTC-116, and HGF-1 cell lines. The effect of polysaccharides on the cell cycle of the HCT-116 cell line was determined for flow cytometry. Fourier Transform-infrared characterization revealed characteristic absorption peaks for polysaccharides, whereas the GC-MS analysis detected three peaks corresponding to D-galactose, galacturonic acid, and D-glucose. The secreted TNF-α concentration was increased when the cell was treated with 2 mg mL−1 polysaccharides, whereas the IL-6 concentration was increased with all of the evaluated polysaccharide concentrations. A cell cycle analysis of HTC-116 treated with polysaccharides evidenced that the acidic polysaccharides from F. chilensis induce an increase in the G0/G1 cell cycle phase, increasing the apoptotic cell percentage. Results from a proteomic analysis suggest that some of the molecular mechanisms involved in their antioxidant and cellular detoxifying effects and justify their traditional use in heart diseases. Proteomic data are available through ProteomeXchange under identifier PXD048361. The study on acidic polysaccharides from F. chilensis has unveiled their diverse biological activities, including antioxidant, anticancer, and immunomodulatory effects. These findings underscore the promising therapeutic applications of acidic polysaccharides from F. chilensis, warranting further pharmaceutical and medicinal research exploration.

The use of functional feeds in aquaculture is currently increasing. This study aimed to assess the combined impact of dietary green microalgae Chlorella fusca and ethanol-inactivated Vibrio proteolyticus DCF12.2 (CVP diet) on thick-lipped grey mullet (Chelon labrosus) juvenile fish. The effects on intestinal microbiota and the transcription of genes related to metabolism, stress, and the immune system were investigated after 90 days of feeding. Additionally, the fish were challenged with Aeromonas hydrophila and polyinosinic–polycytidylic acid (poly I:C) to evaluate the immune response. Microbiota analysis revealed no significant differences in alpha and beta diversity between the anterior and posterior intestinal sections of fish fed the control (CT) and CVP diets. The dominant genera varied between the groups; Pseudomonas and Brevinema were most abundant in the CVP group, whereas Brevinema, Cetobacterium, and Pseudomonas were predominant in the CT group. However, microbial functionality remained unaltered. Gene expression analysis indicated notable changes in hif3α, mhcII, abcb1, mx, and tnfα genes in different fish organs on the CVP diet. In the head kidney, gene expression variations were observed following challenges with A. hydrophila or poly I:C, with higher peak values seen in fish injected with poly I:C. Moreover, c3 mRNA levels were significantly up-regulated in the CVP group 72 h post-A. hydrophila challenge. To conclude, incorporating C. fusca with V. proteolyticus in C. labrosus diet affected the microbial species composition in the intestine while preserving its functionality. In terms of gene expression, the combined diet effectively regulated the transcription of stress and immune-related genes, suggesting potential enhancement of fish resistance against stress and infections.

Brazil was the epicenter of worldwide pandemics at the peak of its second wave. The genomic/proteomic perspective of the COVID-19 pandemic in Brazil could provide insights to understand the global pandemics behavior. In this study, we track SARS-CoV-2 molecular information in Brazil using real-time bioinformatics and data science strategies to provide a comparative and evolutive panorama of the lineages in the country. SWeeP vectors represented the Brazilian and worldwide genomic/proteomic data from Global Initiative on Sharing Avian Influenza Data (GISAID) between February 2020 and August 2021. Clusters were analyzed and compared with PANGO lineages. Hierarchical clustering provided phylogenetic and evolutionary analyses of the lineages, and we tracked the P.1 (Gamma) variant origin. The genomic diversity based on Chao's estimation allowed us to compare richness and coverage among Brazilian states and other representative countries. We found that epidemics in Brazil occurred in two moments with different genetic profiles. The P.1 lineages emerged in the second wave, which was more aggressive. We could not trace the origin of P.1 from the variants present in Brazil. Instead, we found evidence pointing to its external source and a possible recombinant event that may relate P.1 to a B.1.1.28 variant subset. We discussed the potential application of the pipeline for emerging variants detection and the PANGO terminology stability over time. The diversity analysis showed that the low coverage and unbalanced sequencing among states in Brazil could have allowed the silent entry and dissemination of P.1 and other dangerous variants. This study may help to understand the development and consequences of variants of concern (VOC) entry.

One of the main bioactive compounds of interest from the Ulva species is the sulfated polysaccharide ulvan, which has recently attracted attention for its anticancer properties. This study investigated the cytotoxic activity of ulvan polysaccharides obtained from Ulva rigida in the following scenarios: (i) in vitro against healthy and carcinogenic cell lines (1064sk (human fibroblasts), HACAT (immortalized human keratinocytes), U-937 (a human leukemia cell line), G-361 (a human malignant melanoma), and HCT-116 (a colon cancer cell line)) and (ii) in vivo against zebrafish embryos. Ulvan exhibited cytotoxic effects on the three human cancer cell lines tested. However, only HCT-116 demonstrated sufficient sensitivity to this ulvan to make it relevant as a potential anticancer treatment, presenting an LC50 of 0.1 mg mL−1. The in vivo assay on the zebrafish embryos showed a linear relationship between the polysaccharide concentration and growth retardation at 7.8 hpf mL mg−1, with an LC50 of about 5.2 mg mL−1 at 48 hpf. At concentrations near the LC50, toxic effects, such as pericardial edema or chorion lysis, could be found in the experimental larvae. Our in vitro study supports the potential use of polysaccharides extracted from U. rigida as candidates for treating human colon cancer. However, the in vivo assay on zebrafish indicated that the potential use of ulvan as a promising, safe compound should be limited to specific concentrations below 0.001 mg mL−1 since it revealed side effects on the embryonic growth rate and osmolar balance.

Summary: Background: Indigenous peoples are vulnerable to pandemics, including to the coronavirus disease (COVID)-19, since it causes high mortality and specially, the loss of elderly Indigenous individuals. Methods: The epidemiological data of severe acute respiratory syndrome (SARS) by SARS-CoV-2 infection or other etiologic agents (OEA) among Brazilian Indigenous peoples during the first year of COVID-19 pandemic was obtained from a Brazilian Ministry of Health open-access database to perform an observational study. Considering only Indigenous individuals diagnosed with SARS by COVID-19, the epidemiology data were also evaluated as risk of death. The type of sample collection for virus screening, demographic profile, clinical symptoms, comorbidities, and clinical evolution were evaluated. The primary outcome was considered the death in the Brazilian Indigenous individuals and the secondary outcome, the characteristics of Brazilian Indigenous infected by SARS-CoV-2 or OEA, as the need for intensive care unit admission or the need for mechanical ventilation support. The statistical analysis was done using Logistic Regression Model. Alpha of 0.05. Findings: A total of 3,122 cases of Indigenous individuals with SARS in Brazil were reported during the first year of the COVID-19 pandemic. Of these, 1,994 were diagnosed with COVID-19 and 730/1,816 (40.2%) of them died. The death rate among individuals with SARS-CoV-2 was three-fold increased when compared to the group of individuals with OEA. Several symptoms (myalgia, loss of smell, and sore throat) and comorbidities (cardiopathy, systemic arterial hypertension, and diabetes mellitus) were more prevalent in the COVID-19 group when compared to Indigenous individuals with OEA. Similar profile was observed considering the risk of death among the Indigenous individuals with COVID-19 who presented several symptoms (oxygen saturation

Mejillones Bay is located in northern Chile (23°S) and is influenced by an Oxygen Minimum Zone (OMZ), with oxygen levels below 0.5 ml l–1. This area presents particular ecological characteristics, such as circulation of currents, hotspot, high productivity and industrial activity. This extreme ecosystem generates the need to understand their dynamics and changes across time and space, as well as to identify the main differences with other OMZs. For this reason, we studied the benthic foraminifera to use them as environmental and oxygenation proxies. For this purpose, two sediment cores (ZA and Z1A) were collected, obtaining 14 samples of the first 8 cm (vertical distribution), and 18 samples with a mini boxcore (spatial distribution). When analyzing the foraminifera community, some similarities were found in environmental characteristics of other OMZs, such as the predominance of Bolivina seminuda, Bolivina costata, Epistominella exigua, Fursenkoina sp., and Nonioella stella (species typical of hypoxic conditions). In addition, a high abundance of angular-asymmetric morphologies was observed, indicating eutrophied silty substrates and low current circulation. However, the Mejillones Bay recorded a particular spatial and vertical dynamics respect to others OMZs, due to presence of other species of Bolivinids not reported for this area before, and a high abundance of Buliminella elegantissima, which is not recorded in most of OMZs. Foraminifera with rounded-symmetric morphologies were present and dominant in deeper layers, reflecting a turbulent and high-energy environment. On the basis of depth and conditions of microxia or dysoxia, no significative pattern of spatial and vertical distribution was observed. The latter can be explained by local factors such as cyclonic and anticyclonic whirlpools, wastewater from industrial activity and natural disaster such a Tsunami occurred in 1877. These factors contributed to the mixture of the benthic foraminifera and prevented the formation of spatial and vertical patterns. Finally, an intensification of hypoxia was identified, indicating microxia (0,01 ml l–1) in the superficial layers (0–3 cm from years 1996 to 2012), while the deeper layers (4–8 cm from years 1985 to 1877) presented foraminiferal species that indicated dysoxia conditions (0,07 ml l–1). The latter differs from other OMZs, which show greater oxygenation in the most superficial layers and microxia in deeper layers. This study represents the first ecological reconstruction using benthic foraminifera proxies for the Mejillones Bay, which results indicate an OMZ with ecological and environmental features that differ from other OMZs.

The present study was carried out to determine the bioactivity of polysaccharides extracted from Euglena gracilis (EgPs). These were characterized by FT-IR and GC-MS. Cytotoxicity analyses (MTT) were performed on healthy human gingival fibroblast cell lines (HGF-1), obtaining an IC50 of 228.66 µg mL−1, and cell lines with anticancer activity for colon cancer (HCT-116), breast cancer (MCF-7), human leukemia (U-937, HL-60) and lung cancer (NCl-H460), showing that EgPs have anticancer activity, mainly in HTC-116 cells (IC50 = 26.1 µg mL−1). The immunological assay determined the immunomodulatory capacity of polysaccharides for the production of proinflammatory cytokines IL-6 and TNF-α in murine macrophages (RAW 264.7) and TNF-α in human monocytes (THP-1). It was observed that the EgPs had a stimulating capacity in the synthesis of these interleukins. The antioxidant capacity of polysaccharides and their biomass were analyzed using the ABTS method (18.30 ± 0.14% and (5.40 ± 0.56%, respectively, and the DPPH method for biomass (17.79 ± 0.57%). We quantitatively profiled HGF-1 proteins by liquid chromatography–tandem mass spectrometry analysis, coupled with 2-plex tandem mass tag labelling, in normal cells. In total, 1346 proteins were identified and quantified with high confidence, of which five were considered to be overexpressed. The data is available through ProteomeXchange, under identifier PXD029076.

Abstract Background Herbaspirillum seropedicae is an environmental β-proteobacterium that is capable of promoting the growth of economically relevant plants through biological nitrogen fixation and phytohormone production. However, strains of H. seropedicae have been isolated from immunocompromised patients and associated with human infections and deaths. In this work, we sequenced the genomes of two clinical strains of H. seropedicae, AU14040 and AU13965, and compared them with the genomes of strains described as having an environmental origin. Results Both genomes were closed, indicating a single circular chromosome; however, strain AU13965 also carried a plasmid of 42,977 bp, the first described in the genus Herbaspirillum. Genome comparison revealed that the clinical strains lost the gene sets related to biological nitrogen fixation (nif) and the type 3 secretion system (T3SS), which has been described to be essential for interactions with plants. Comparison of the pan-genomes of clinical and environmental strains revealed different sets of accessorial genes. However, antimicrobial resistance genes were found in the same proportion in all analyzed genomes. The clinical strains also acquired new genes and genomic islands that may be related to host interactions. Among the acquired islands was a cluster of genes related to lipopolysaccharide (LPS) biosynthesis. Although highly conserved in environmental strains, the LPS biosynthesis genes in the two clinical strains presented unique and non-orthologous genes within the genus Herbaspirillum. Furthermore, the AU14040 strain cluster contained the neuABC genes, which are responsible for sialic acid (Neu5Ac) biosynthesis, indicating that this bacterium could add it to its lipopolysaccharide. The Neu5Ac-linked LPS could increase the bacterial resilience in the host aiding in the evasion of the immune system. Conclusions Our findings suggest that the lifestyle transition from environment to opportunist led to the loss and acquisition of specific genes allowing adaptations to colonize and survive in new hosts. It is possible that these substitutions may be the starting point for interactions with new hosts.

Codium bernabei is a green alga that grows on Chilean coasts. The composition of its structural polysaccharides is still unknown. Hence, the aim of this work is to isolate and characterize the hot water extracted polysaccharide fractions. For this purpose, the water extracts were further precipitated in alcohol (TPs) and acid media (APs), respectively. Both fractions were characterized using different physicochemical techniques such as GC-MS, GPC, FTIR, TGA, and SEM. It is confirmed that the extracted fractions are mainly made of sulfated galactan unit, with a degree of sulfation of 19.3% (TPs) and 17.4% (ATs) and a protein content of 3.5% in APs and 15.6% in TPs. Other neutral sugars such as xylose, glucose, galactose, fucose, mannose, and arabinose were found in a molar ratio (0.05:0.6:1.0:0.02:0.14:0.11) for TPs and (0.05:0.31:1.0:0.03:0.1:0.13) for ATs. The molecular weight of the polysaccharide samples was lower than 20 kDa. Both polysaccharides were thermally stable (Tonset > 190 °C) and showed antioxidant activity according to the ABTS•+ and DPPH tests, where TPs fractions had higher scavenging activity (35%) compared to the APs fractions. The PT and APTTS assays were used to measure the anticoagulant activity of the polysaccharide fractions. In general, the PT activity of the TPs and APs was not different from normal plasma values. The exception was the TPs treatment at 1000 µg mL−1 concentration. The APTTS test revealed that clotting time for both polysaccharides was prolonged regarding normal values at 1000 µg mL−1. Finally, the antitumor test in colorectal carcinoma (HTC-116) cell line, breast cancer (MCF-7) and human leukemia (HL-60) cell lines showed the cytotoxic effect of TPs and APs. Those results suggest the potential biotechnological application of sulfate galactan polysaccharides isolated from a Chilean marine resource.

Objective: To analyze and compare lung function of obese and healthy, normal‐weight children and adolescents, without asthma, through spirometry and volumetric capnography. Methods: Cross‐sectional study including 77 subjects (38 obese) aged 5–17 years. All subjects underwent spirometry and volumetric capnography. The evaluations were repeated in obese subjects after the use of a bronchodilator. Results: At the spirometry assessment, obese individuals, when compared with the control group, showed lower values of forced expiratory volume in the first second by forced vital capacity (FEV1/FVC) and expiratory flows at 75% and between 25 and 75% of the FVC (p 11 years (p

Porphyridium cruentum is a unicellular microalga that can synthesize and secrete to the culture medium-high amounts of polysaccharides. In this study, the immunomodulatory, cytotoxic effect and antioxidant activity of the sulfated polysaccharides (PcSPs) were determinate. The PcSPs were precipitated with 2% Cetylpyridinium bromide hydrate and ethanol and purified by dialysis. The extract was lyophilized for its characterization by Fourier transform-Infrared (FT-IR) spectroscopy and gas chromatography–mass spectrometry (GC-MS). The antioxidant activity of PcSPs were examined with assay 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) and compared with that of the biomass, observing significant differences between the results obtained from the PcSPs and biomass. To determine their ability to induce cytokine production Tumor Necrosis Factor alpha (TNF-α) and interleukina-6 (IL-6), the immunomodulatory activity of the PcSPs has been evaluated. In the mouse macrophage cell line (RAW 264.7), PcSPs are potent inducers of IL-6 cytokines but mainly of TNF-α. The cytotoxic capacity of PcSPs was measured by the MTT colorimetric assay in colorectal carcinoma (HTC-116), human leukemia (U-937 and HL-60), breast cancer (MCF-7), lung cancer (NCI-H460) and human gingival fibroblasts (HGF-1) cell lines. The IC50 value of 2311.20 µg mL−1, 1676.74 µg mL−1, 1089.63 µg mL−1, 5498.14 µg mL−1 and 2861.49 µg mL−1 respectively in the tumor lines and 5022.55 µg mL−1 in gingival fibroblasts were obtained. Our study suggested that PcSPs from P. cruentum have a moderate immunomodulatory and cytotoxic effect. The results obtained indicate that the polysaccharides from P. cruentum are potent inducers of IL-6 cytokines and, most importantly, of TNF-α. PcSPs showed no evidence of antigenic activity or hypersensitivity when administered intraperitoneally in mice. Furthermore, the in vivo study revealed an improvement of local inflammatory response against stress in the peritoneum. These findings suggest that the PcSPs from P. cruentum might have potential as a valuable ingredient in nutraceutical products.

Aims: Pulmonary arterial hypertension (PAH) is a disease characterized by an increase in pulmonary vascular resistance and right ventricular (RV) failure. We aimed to determine the effects of human mesenchymal stem cell (hMSC) therapy in a SU5416/hypoxia (SuH) mice model of PAH.Methods and Results: C57BL/6 mice (20–25 g) were exposure to 4 weeks of hypoxia combined vascular endothelial growth factor receptor antagonism (20 mg/kg SU5416; weekly s.c. injections; PAH mice). Control mice were housed in room air. Following 2 weeks of SuH exposure, we injected 5 × 105 hMSCs cells suspended in 50 μL of vehicle (0.6 U/mL DNaseI in PBS) through intravenous injection in the caudal vein. PAH mice were treated only with vehicle. Ratio between pulmonary artery acceleration time and RV ejection time (PAAT/RVET), measure by echocardiography, was significantly reduced in the PAH mice, compared with controls, and therapy with hMSCs normalized this. Significant muscularization of the PA was observed in the PAH mice and hMSC reduced the number of fully muscularized vessels. RV free wall thickness was higher in PAH animals than in the controls, and a single injection of hMSCs reversed RV hypertrophy. Levels of markers of exacerbated apoptosis, tissue inflammation and damage, cell proliferation and oxidative stress were significantly greater in both lungs and RV tissues from PAH group, compared to controls. hMSC injection in PAH animals normalized the expression of these molecules which are involved with PAH and RV dysfunction development and the state of chronicity.Conclusion: These results indicate that hMSCs therapy represents a novel strategy for the treatment of PAH in the future.

Pulmonary arterial hypertension (PAH) is a clinical condition characterized by pulmonary arterial remodeling and vasoconstriction, which promote chronic vessel obstruction and elevation of pulmonary vascular resistance. Long-term right ventricular (RV) overload leads to RV dysfunction and failure, which are the main determinants of life expectancy in PAH subjects. Therapeutic options for PAH remain limited, despite the introduction of prostacyclin analogs, endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, and soluble guanylyl cyclase stimulators within the last 15 years. Through addressing the pulmonary endothelial and smooth muscle cell dysfunctions associated with PAH, these interventions delay disease progression but do not offer a cure. Emerging approaches to improve treatment efficacy have focused on beneficial actions to both the pulmonary vasculature and myocardium, and several new targets have been investigated and validated in experimental PAH models. Herein, we review the effects of adenosine and adenosine receptors (A1, A2A, A2B, and A3) on the cardiovascular system, focusing on the A2A receptor as a pharmacological target. This receptor induces pulmonary vascular and heart protection in experimental models, specifically models of PAH. Targeting the A2A receptor could potentially serve as a novel and efficient approach for treating PAH and concomitant RV failure. A2A receptor activation induces pulmonary endothelial nitric oxide synthesis, smooth muscle cell hyperpolarization, and vasodilation, with important antiproliferative activities through the inhibition of collagen deposition and vessel wall remodeling in the pulmonary arterioles. The pleiotropic potential of A2A receptor activation is highlighted by its additional expression in the heart tissue, where it participates in the regulation of intracellular calcium handling and maintenance of heart chamber structure and function. In this way, the activation of A2A receptor could prevent the production of a hypertrophic and dysfunctional phenotype in animal models of cardiovascular diseases.

Fonsecaea and Cladophialophora are genera of black yeast-like fungi harboring agents of a mutilating implantation disease in humans, along with strictly environmental species. The current hypothesis suggests that those species reside in somewhat adverse microhabitats, and pathogenic siblings share virulence factors enabling survival in mammal tissue after coincidental inoculation driven by pathogenic adaptation. A comparative genomic analysis of environmental and pathogenic siblings of Fonsecaea and Cladophialophora was undertaken, including de novo assembly of F. erecta from plant material. The genome size of Fonsecaea species varied between 33.39 and 35.23 Mb, and the core genomes of those species comprises almost 70% of the genes. Expansions of protein domains such as glyoxalases and peptidases suggested ability for pathogenicity in clinical agents, while the use of nitrogen and degradation of phenolic compounds was enriched in environmental species. The similarity of carbohydrate-active vs. protein-degrading enzymes associated with the occurrence of virulence factors suggested a general tolerance to extreme conditions, which might explain the opportunistic tendency of Fonsecaea sibling species. Virulence was tested in the Galleria mellonella model and immunological assays were performed in order to support this hypothesis. Larvae infected by environmental F. erecta had a lower survival. Fungal macrophage murine co-culture showed that F. erecta induced high levels of TNF-α contributing to macrophage activation that could increase the ability to control intracellular fungal growth although hyphal death were not observed, suggesting a higher level of extremotolerance of environmental species.

Objective: We tested the hypothesis that direct intramyocardial injection of bone marrow mononuclear cells in patients with non-ischemic dilated cardiomyopathy can improve left ventricular function and physical capacity. Methods: Thirty non-ischemic dilated cardiomyopathy patients with left ventricular ejection fraction

OBJECTIVES: Proper assessment of dyspnea is important in patients with heart failure. Our aim was to evaluate the use of the 5-point Likert scale for dyspnea to assess the degree of pulmonary congestion and to determine the prognostic value of this scale for predicting adverse events in heart failure outpatients. METHODS: We undertook a prospective study of outpatients with moderate to severe heart failure. The 5-point Likert scale was applied during regular outpatient visits, along with clinical assessments. Lung ultrasound with ≥15 B-lines and an amino-terminal portion of pro-B-type natriuretic peptide (NT-proBNP) level >1000 pg/mL were used as a reference for pulmonary congestion. The patients were then assessed every 30 days during follow-up to identify adverse clinical outcomes. RESULTS: We included 58 patients (65.5% male, age 43.5±11 years) with a mean left ventricular ejection fraction of 27±6%. In total, 29.3% of these patients had heart failure with ischemic etiology. Additionally, pulmonary congestion, as diagnosed by lung ultrasound, was present in 58% of patients. A higher degree of dyspnea (3 or 4 points on the 5-point Likert scale) was significantly correlated with a higher number of B-lines (p = 0.016). Patients stratified into Likert = 3-4 were at increased risk of admission compared with those in class 1-2 after adjusting for age, left ventricular ejection fraction, New York Heart Association functional class and levels of NT-proBNP >1000 pg/mL (HR = 4.9, 95% CI 1.33-18.64, p = 0.017). CONCLUSION: In our series, higher baseline scores on the 5-point Likert scale were related to pulmonary congestion and were independently associated with adverse events during follow-up. This simple clinical tool can help to identify patients who are more likely to decompensate and whose treatment should be intensified.

This study was designed to evaluate the potential use of algal extracts in cosmeceuticals, including factors related to biosecurity. The aqueous crude extracts of Hydropuntia cornea and Gracilariopsis longissima showed a good photoprotective capacity (Sun Protection Factor, SPF) due to, among other reasons, the presence of five types of mycosporine-like amino acids (MAAs) detected by high pressure liquid chromatography-photodiode array detector (HPLC-PDA) and electrospray ionization mass spectrometry (ESI-MS) (Palythine, Asterina-330, Shinorine, Porphyra-334, and Palythinol). The toxicity of the extracts was evaluated by the MTT assay, which is based on the metabolic reduction of MTT [3-(4,5-dimethylthiazol-2yl)-diphenyl tetrazolium bromide] by the action of the mitochondrial enzyme succinate dehydrogenase. This assay was carried out in vitro in three cell lines: one related to the immune system (murine macrophages of the immune system: RAW264.7) and two human cell lines related to the skin (gingival fibroblasts: HGF, and immortalized human keratinocytes: HaCaT). Both extracts showed no cytotoxic activity in both types of human cells, whereas they showed cytotoxicity in murine tumor cells of the immune system (macrophages: RAW264.7). On the other hand, the immunological activity in the murine macrophage RAW264.7 was studied at a concentration lower than 100 μg mL−1 and lower than the EC50, and evaluated by the production of pro-inflammatory compounds through an immunosorbent assay linked to enzymes such as tumor necrosis factor-α (TNF-α) or anti-inflammatory/proinflammatory enzymes such as interleukin-6 (IL-6). Both algae extracts induced the biosynthesis of TNF-α and IL-6. The production of TNF-α was much higher than that observed in the control (at a concentration of the aqueous extract higher than 5 μg mL−1). These results support the theory that the extracts of H. cornea and G. longissima actively induce the production of cytokines. In summary, the extracts of these species did not show cytotoxicity in human cells, and they present with immunomodulatory and photoprotection capacity.

FUNDAMENTO: O fator de crescimento endotelial vascular (VEGF - vascular endothelial growth factor) induz a mobilização de células progenitoras endoteliais (CPEs) com capacidade de proliferação e diferenciação em células endoteliais, contribuindo, dessa forma, para o processo angiogênico. OBJETIVO: Buscamos avaliar o comportamento de CPEs em pacientes com doença cardíaca isquêmica e angina refratária que receberam injeções intramiocardicas de 2000 µg de VEGF165 como terapia única. MÉTODOS: O estudo foi uma subanálise de um ensaio clínico. Pacientes com doença cardíaca isquêmica avançada e angina refratária foram avaliados para inclusão no estudo. Os critérios de inclusão foram: sinais e sintomas de angina e/ou insuficiência cardíaca apesar de tratamento medicamentoso máximo e área de isquemia miocárdica de, no mínimo, 5% conforme avaliado por uma tomografia computadorizada por emissão de fóton único (TCEFU). Os critérios de exclusão foram: idade > 65 anos, fração de ejeção do ventrículo esquerdo < 25% e cancer diagnosticado. Os pacientes cujos níveis de CPE foram avaliados foram incluídos. A intervenção consistiu na administração de 2000 µg de VEGF 165 de plasmídeo injetado no miocárdio isquêmico. A frequência de células CD34+/KDR+ foi analisada por citometria de fluxo antes e 3, 9, e 27 dias após a intervenção. RESULTADOS: Um total de 9 pacientes foram incluídos, 8 homens, média de idade de 59,4 anos, fração de ejeção ventricular esquerda de 59,3%, e classe de angina predominante III. Observou-se um aumento significativo dos níveis de CPEs no terceiro dia após a intervenção. Todavia, 9 e 27 dias após a intervenção, os níveis de CPEs foram similares aos basais. CONCLUSÃO: Identificamos uma mobilização transitória de CPE, com pico no terceiro dia após a intervenção com VEGF 165 em pacientes com angina refratária. Todavia, os níveis de CPEs apresentaram-se semelhantes aos basais 9 e 27 dias após a intervenção.

Cardiopatia isquêmica grave com angina refratária a formas convencionais de tratamento apresenta-se em uma crescente incidência. Para tratar angina refratária, terapias alternativas na tentativa de redução da isquemia miocárdica e alívio de sintomas têm sido estudadas. Neste contexto, a terapia gênica representa uma opção, pela possibilidade de induzir angiogênese, estabelecer circulação colateral e reperfundir miocárdio isquêmico. Diversos ensaios clínicos têm sido conduzidos e, com exceção de casos isolados e específicos de efeitos adversos, há indicação de segurança, viabilidade e potencial eficácia da terapia. O benefício clínico não está bem definido. Neste artigo, revisamos os ensaios clínicos que utilizaram terapia gênica para tratamento de pacientes cardiopatas isquêmicos. A abordagem inclui: (1) isquemia miocárdica e angiogênese, sobre os aspectos fisiopatológicos envolvidos; (2) fatores de crescimento, tratando sobre aspectos específicos e justificando a utilização em pacientes cardiopatas isquêmicos sem opções pela terapêutica convencional; (3) ensaios clínicos controlados, onde é apresentado um resumo dos principais estudos envolvendo terapia gênica para tratamento da cardiopatia isquêmica grave; (4) nossa experiência, especialmente sobre resultados preliminares do primeiro ensaio clínico de terapia gênica do Brasil e (5) perspectivas.Severe ischemic heart disease with refractory angina, occurs in increasing incidence. Alternative forms of treatment, in an attempt to reduce myocardial ischemia and relief of symptoms has been studied. In this context, gene therapy is an option, for the possibility of inducing angiogenesis, establish collateral circulation and reperfuse ischemic myocardium. Several clinical trials have been conducted and, except for specific cases of adverse effects, there is indication of safety, feasibility and potential effectiveness of therapy. The clinical benefit, however, is not yet well established. In this article we review the clinical trials of gene therapy for patients with ischemic heart disease. The approach includes: (1) myocardial ischemia and angiogenesis on the pathophysiological aspects involved, (2) growth factors, dealing with specific aspects and justifying the use in cardiac patients with no option for conventional therapy, (3) controlled clinical trials, where a summary of the main studies involving gene therapy for severe ischemic heart disease is presented, (4) our experience, especially on preliminary results of the first gene therapy clinical trial in Brazil and (5) future prospects.

FUNDAMENTO: O tramadol é um analgésico de ação central cujo mecanismo de ação envolve a ativação de um receptor opioide. Anteriormente, mostramos que o tramadol e seus enantiômeros apresentavam um efeito inotrópico negativo sobre o músculo papilar no qual o (+)-enantiômero era mais potente que (-)- e (±)-tramadol. OBJETIVO: No presente trabalho, investigamos os efeitos do tramadol e seus enantiômeros na corrente de cálcio tipo L (I Ca-L). MÉTODOS: Os experimentos foram realizados em miócitos ventriculares isolados de ratos Wistar utilizando a técnica de patch-clamp com configuração de célula inteira. RESULTADOS: O tramadol (200 µM) reduziu a amplitude de pico do I Ca-L em potenciais de 0 a +50 mV. Em 0 mV, a I Ca-L foi reduzida em 33,7 ± 7,2%. (+)- e (-)-tramadol (200 µM) produziram uma inibição semelhante da I Ca-L, na qual a amplitude do pico foi reduzida em 64,4 ± 2,8% e 68,9 ± 5,8%, respectivamente a 0 mV (P > 0,05). O tramadol, (+)- e (-)-tramadol mudaram a inativação de estado estacionário de I Ca-L para potenciais de membrana mais negativos. Além disso, tramadol e (+)-tramadol alteraram significativamente a curva de recuperação dependente de tempo da I Ca-L para a direita e reduziram a recuperação de I Ca-L da inativação. A constante de tempo foi aumentada de 175,6 ± 18,6 a 305,0 ± 32,9 ms (P < 0,01) para o tramadol e de 248,1 ± 28,1 ms para 359,0 ± 23,8 ms (P < 0,05) para o (+)-tramadol. O agonista do receptor µ-opioide (DAMGO) não tem nenhum efeito na I Ca-L. CONCLUSÃO: A inibição da I Ca-L induzida por tramadol e seus enantiômeros não teve relação com a ativação de receptores opioides e poderia explicar, pelo menos em parte, seu efeito inotrópico negativo cardíaco.BACKGROUND: Tramadol is a centrally acting analgesic, whose mechanism of action involves opioid-receptor activation. Previously, we have shown that tramadol and its enantiomers had a negative inotropic effect on the papillary muscle in which the (+)-enantiomer is more potent than (-)- and (±)-tramadol. OBJECTIVE: In this study, we investigated the effects of tramadol and its enantiomers on L-type calcium current (I Ca-L). RESULTS: Tramadol (200 µM) reduced the peak amplitude of I Ca-L at potentials from 0 to +50 mV. At 0 mV, I Ca-L was reduced by 33.7 ± 7.2%. (+)- and (-)-tramadol (200 µM) produced a similar inhibition of I Ca-L, in which the peak amplitude was reduced by 64.4 ± 2.8% and 68.9 ± 5.8%, respectively at 0 mV (p > 0.05). Tramadol, (+)- and (-)-tramadol shifted the steady-state inactivation of I Ca-L to more negative membrane potentials. Also, tramadol and (+)-tramadol markedly shifted the time-dependent recovery curve of I Ca-L to the right and slowed down the recovery of I Ca-L from inactivation. The time constant was increased from 175.6 ± 18.6 to 305.0 ± 32.9 ms (p < 0.01) for tramadol and from 248.1 ± 28.1 ms to 359.0 ± 23.8 ms (p < 0.05) for (+)-tramadol. The agonist of µ-opioid receptor DAMGO had no effect on the I Ca-L. CONCLUSION: The inhibition of I Ca-L induced by tramadol and its enantiomers was unrelated to the activation of opioid receptors and could explain, at least in part, their negative cardiac inotropic effect.

OBJECTIVE: Therapeutic angiogenesis is currently under investigation in ischemic heart disease. We examined the effect on left ventricular function induced by therapeutic angiogenesis by intramyocardial injection of plasmid VEGF165, in a canine model of chronic myocardial infarction. METHODS: Left thoracotomy was performed in 10 mongrel dogs, and myocardial infarction induced by ligation of the major diagonal coronary artery. At 7 postoperative (p.o.) day (pre-treatment), left ventricular ejection fraction was assessed by echocardiogram, and a second procedure was done: saline or plasmid VEGF165 at 200 mg/mL was injected over 10 points of the ischemic areas of control or treated groups, respectively. Fourteen days later (post-treatment, day 21) a control echocardiogram was performed, the animals were sacrificed and histological examination was performed. RESULTS: Ejection fraction was maintained in the treated group: 52.45 + 15.1% on day 7 and 48.53 + 11.74% on day 21 (P=0.59), and tended to decrease in the control group, from 59.3 + 4% to 39.37 + 19.43% (P=0.04), although absolute values did not differ significantly between groups. Histological examination revealed a non significant increase in capillary vessels number in all areas in treated group. Paradoxically, arterioles were significantly less in number in all areas of treated dogs. CONCLUSION: Intramyocardial injection of plasmid VEGF165, in this canine model of chronic myocardial infarction, resulted in preservation of left ventricular ejection fraction, contrary to the control group where left ventricular ejection fraction showed continuous decline during the experiment. Histological examination, however, was unable to explain completely these results.OBJETIVO: Angiogênese por terapia gênica é alternativa ainda experimental para revascularização miocárdica. Este estudo objetivou verificar a indução de angiogênese e melhora funcional miocárdica pela injeção transmural de plasmídeo contendo VEGF165 em áreas de infarto crônico do miocárdio. MÉTODOS: Em 10 cães anestesiados, por toracotomia lateral esquerda, foi induzido infarto agudo do miocárdio (IAM) por meio da ligadura do ramo diagonal principal da art��ria coronária descendente anterior. Após 7 dias, realizado ecocardiograma para avaliação da fração de ejeção (FE) ventricular esquerda. Os animais foram divididos em dois grupos: Tratado (GT) e Controle (GC) e submetidos a segundo procedimento, para injeção intramiocárdica de solução contendo plasmídeo VEGF165 na concentração de 200mg/ml (GT) ou solução salina (GC), distribuída em 10 pontos da área infartada. Após 14 dias, novo ecocardiograma, sacrifício dos animais e retirada do coração para estudo histológico. RESULTADOS: Houve tendência à manutenção da FE no GT e de queda da FE no GC, conforme os valores: FE ao ecocardiograma pós-IAM inicial: GC 59,33 + 4,6% e GT 52,45 + 15,1% (P=0,359). FE após 14 dias: GC 39,37 + 19,43% e GT 48,53 + 11,74% (P=0,394). Comparação intra-grupo: Variação negativa da FEVE GC: 59,37 + 4% para 39,37 + 19,43% (P=0,04) e manutenção GT: 52,45 + 15,1% para 48,53 + 11,74% (P=0,59). No GT observou-se aumento do número de vasos capilares, mais intenso nas regiões injetadas, porém presente em todo miocárdio. Paradoxalmente, no GT houve redução do número de arteríolas. CONCLUSÃO: A injeção transmural de plasmídeo VEGF165 resultou em tendência para atenuar a perda de contratilidade consequente ao dano miocárdico, na fase crônica do IAM. O exame histológico da rede vascular, entretanto, não explica completamente os eventos funcionais.

Nos últimos anos, a terapia de ressincronização cardíaca tem sido uma conduta bem definida para pacientes com insuficiência cardíaca (IC), classe funcional III ou IV, que não tiveram resposta à otimização terapêutica. Estudos já mostraram esta eficácia, mas um grupo bem definido de miocardiopatias dilatadas com áreas de fibrose não tem tido o mesmo sucesso (30%-40%). Por isto decidimos associar a estes pacientes o implante de células-tronco. A partir de 04/2005 iniciamos estes implantes em pacientes (pcs.) com IC, classe funcional III/IV, otmizados e fração de ejeção In recent years cardiac resynchronization therapy has been a well defined approach for patients with functional class III or IV heart failure (HF) who do not respond to optimized therapy. Studies have shown efficacy, but one well defined group of dilated heart diseases with large areas of fibrosis has not had the same success rates (30-40%). Hence, we decided to associate stem cell transplant in these patients. Since April 2005 we started to transplant stem cells in 25 patients (16 men) with NYHA III/IV HF with ejection fraction < 35% and ventricle dyssynchrony. Their ages varied between 30 and 80, (mean age 58) and 44% (11 patients) had a chagasic etiology. Resynchronization and stem cell therapy were performed via epicardial (12) or endocardial (13) approaches. Cell selection was by Ficoll filtration with a mean number of 3.0 x 108 cells infused: CD 34+ (5.0 x 106) and CD 133+ (2.5 x 106). In 24 months of evolution we noticed that 84.8% of these patients survived and mortality (15.2%) was not related to the procedure. The survival of pacemaker recipients (52.4%) was higher than another similar group that did not receive pacemaker implants and chagasic patients survived less than the ischemic and the idiopathic patients (42.4%, 55.6% and 77.2%, respectively). In spite of these initial differences, there was no statistical difference between these groups (log-rank test of P=0.218 and P= 0.626, respectively). In cases that resynchronization was performed in isolation, the results do not seem to be satisfactory so we chose to associate stem cell therapy as a safe and adequate alternative for patients with HF and dilated myocardiopathy.

The immunophilin 12-kDa FK506 binding protein (FKBP12) stabilizes intracellular Ca2+ release channel (CRC) activity in different tissues. In this work, the presence of FKBP12 in rat vas deferens (RVD) and its possible contribution to RVD function was investigated. Treatment under appropriate pH, temperature, and ionic conditions was used to strip FKBP12 from CRC binding sites; Western blotting revealed FKBP12 in control but not in treated homogenates. Disruption of the FKBP12-CRC complex in RVD decreased the Ca2+ content of sarcoplasmic reticulum (SR) by increasing Ca2+ leakage through the ryanodine receptor (RyR3 isoform) but not through 1,4,5-iNOSitol trisphosphate receptors (IP3R1 and IP3R3 isoforms). The decrease of SR Ca2+ content was not related to inhibition of SERCA ATPase. It seems that dissociation of FKBP12-RyR leads to conformational changes in RyR that make it difficult for ryanodine to access its binding site. Rapamycin, which is commonly used as a pharmacological tool to disrupt the FKBP12-RyR complex, decreased phenylephrine-induced contractions in RVD epididymal halves. The data suggest that FKBP12 is expressed in RVD in a labile association with RyR3. Disruption of the FKBP12-RyR3 complex may lead to modifications of RVD physiology and in consequence may compromise male fertility. Keywords:: calcium, 12-kDa FK506 binding protein (FKBP12), ryanodine receptor, SERCA, rat vas deferens

O Brasil é o maior produtor mundial de citros, com destaque para o Estado de São Paulo, maior produtor nacional. Recentes estudos mostram que a área irrigada de citros em São Paulo tem aumentado significativamente nos últimos anos. Porém, a falta de informações sobre o manejo eficiente da irrigação na cultura de citros é uma das principais dificuldades enfrentadas pelos produtores. Com o intuito de atender a essa necessidade, este trabalho teve como objetivos determinar a evapotranspiração de uma planta adulta de limeira-ácida 'Tahiti' (Citrus latifolia Tan.) e o coeficiente de cultivo (Kc) no período seco (outono-inverno), utilizando a técnica de lisimetria de pesagem. O experimento foi realizado na ESALQ/USP em Piracicaba - SP, em área irrigada por gotejamento, com plantas espaçadas de 7 x 4 m, sendo cada planta atendida por quatro pontos de molhamento no solo, distribuídos de forma equidistantes entre si. Foi realizado o monitoramento climático, utilizando estação meteorológica automatizada, e a determinação da evapotranspiração da cultura por lisímetro de pesagem. Durante o período de estudo, o Kc variou entre 0,82 e 1,18, e a ETc variou entre 1,2 e 5,6.Brazil is the largest world producer of citrus crop, with São Paulo state leading as the largest national producer. Recent studies show that irrigated areas of citrus in the state have been increasing significantly in the last few years. However, lack of information on irrigation management related to this crop is one of the main problems encountered by the farmers. In order to help solve the above problem, the objective of this work was to determine the evapotranspiration of acid lime adult plant variety 'Tahiti' (Citrus latifolia Tan.) and the crop coefficient during dry period (autumn - winter) using a weighing lysimeter technique. The experiment was carried out at ESALQ/USP in Piracicaba - SP, Brazil, in a drip irrigated area with plant spacing of 7 x 4 m. Each plant was supplied with four wetting equidistant emitters. The climatic data was obtained by the use of automated meteorological station and the crop evapotraspiration by the use of a weighting lysimeter. During the study period, Kc varied from 0.82 to 1.18, and Etc varied from 1.20 to 5.6.

OBJETIVO: O estudo objetiva verificar aplicabilidade do escore de Ambler para pacientes que receberam implante bioprótese de pericárdio bovino no Instituto de Cardiologia do RGS/FUC e quantificar os fatores de risco. MÉTODOS: Estudo retrospectivo com 703 pacientes submetidos ao implante de bioprótese de pericárdio bovino entre 1991 e 2005, no Instituto de Cardiologia do RS. Em 392 pacientes, ocorreu implante aórtico, em 250, mitral e, em 61, combinado. Desfecho primário foi mortalidade hospitalar. As características estimativas do risco foram: idade, sexo, IMC, classe funcional (NYHA), fração de ejeção ventricular esquerda (FE), lesão valvar, hipertensão arterial sistêmica, diabete melito, função renal, ritmo cardíaco, cirurgia cardíaca prévia, revascularização miocárdica e/ou plastia tricúspide concomitante, caráter cirúrgico. Utilizada regressão logística uni e multivariada para quantificar fatores de risco preponderantes, pelo odds ratio (OR). RESULTADOS: A mortalidade observada foi de 14,3%, superior à prevista de valor 3% para escore médio 6 de Ambler, (p 80 anos (OR=6,10). A área sob curva ROC para nossa amostra foi calculada em 72,9% (aceitável > 70%). CONCLUSÃO: A mortalidade prevista no escore de Ambler não é reproduzida no resultado observado, mas a curva ROC evidenciou que o modelo é aplicável. Fatores de risco preponderantes foram individualizados.OBJETIVES: This study aims to verify the applicability of Ambler's risk score to patients who have undergone implantation of bovine pericardial bioprosthesis at the Instituto de Cardiologia do RGS/FCU. This study also aims to quantify the risk factors. METHODS: Retrospective study with 703 patients who had undergone implantation of bovine pericardial bioprosthesis between 1991 and 2005 at the Instituto de Cardiologia do RS. Aortic implant occurred in 392 patients, mitral in 250 and combined in 61. Primary outcome was hospital mortality. Characteristics used to estimate risk were: gender, age, body mass index (BMI), NYHA functional class, left ventricular ejection fraction, valvular lesions, systemic arterial hypertension, diabetes mellitus, renal function, cardiac rhythm, previous cardiac operations, and surgical priority. Univariate and multivariate logistic regression was used to quantify preponderant risk factors by the odds-ratio (OR). RESULTS: The mortality rate was 14.3%, which was higher than the estimated mortality rate (3%, according to Ambler's mean score of 6, (p 70%). CONCLUSION: The mortality predicted in Ambler's score was not reproduced in the observed results. However, the ROC curve provides evidence that this model is applicable. Preponderant risk factors were individualizated.

FUNDAMENTO: Identificação de fatores de risco pré-operatórios na cirurgia cardíaca valvar visa melhor resultado cirúrgico pela possível neutralização de condições relacionadas com morbi-mortalidade aumentada. OBJETIVO: Este estudo objetiva identificar fatores de risco hospitalar em pacientes submetidos a implante de bioprótese de pericárdio bovino. MÉTODOS: Estudo retrospectivo incluindo 703 pacientes consecutivos submetidos a implante de pelo menos uma bioprótese de pericárdio bovino St. Jude Medical-Biocor® de setembro de 1991 a dezembro de 2005 no Instituto de Cardiologia do RS, sendo 392 aórticos, 250 mitrais e 61 mitro-aórticos. Analisadas as características sexo, idade, índice de massa corporal, classe funcional (New York Heart Association - NYHA), fração de ejeção, lesão valvar, hipertensão arterial sistêmica, diabete melito, função renal, arritmias cardíacas, cirurgia cardíaca prévia, revascularização miocárdica, plastia tricúspide e caráter eletivo, de urgência ou de emergência da cirurgia. Desfecho primordial foi mortalidade hospitalar. Utilizou-se regressão logística para examinar relação entre fatores de risco e mortalidade hospitalar. RESULTADOS: Ocorreram 101 (14,3%) óbitos hospitalares. Características significativamente relacionadas à mortalidade aumentada foram sexo feminino (p 2,4mg/dl (p=0,004), classe funcional IV (pBACKGROUND: Identification of preoperative heart valve surgery risk factors aim to improve surgical outcomes with the possibility to offset conditions related to increased morbidity and mortality. OBJECTIVE: Intent of this study is to identify hospital risk factors in patients undergoing bovine pericardial bioprosthesis implantation. METHODS: Retrospective study including 703 consecutive patients who underwent implantation of at least one St. Jude Medical-Biocor™ bovine pericardial bioprosthesis between September 1991 and December 2005 at the Rio Grande do Sul Cardiology Institute; 392 were aortic, 250 were mitral and 61 were mitroaortic. Characteristics analyzed were gender, age, body mass index, NYHA (New York Heart Association) functional class, ejection fraction, valve lesions, systemic hypertension, diabetes mellitus, kidney function, arrhythmias, prior heart surgery, coronary artery bypass graft, tricuspid valve surgery and elective, urgent or emergency surgery. Main outcome was in-hospital mortality. Relationship between risk factors and in-hospital mortality was analyzed using logistic regression. RESULTS: Were 101 (14.3%) in-hospital deaths. Characteristics with significant relationship to increased mortality were female gender (p 2.4mg/dl (p=0.004), functional class IV (p

OBJETIVO: Comparar perfil clínico e cirúrgico entre dois grupos de pacientes submetidos a Cirurgia de Revascularização Miocárdica (CRM) no Instituto de Cardiologia do Rio Grande do Sul, com intervalo de 10 anos; observar sua influência na mortalidade hospitalar e verificar previsibilidade deste resultado mediante escore de risco. MÉTODOS: Estudo de coorte retrospectivo, envolvendo 307 pacientes submetidos a CRM isolada em período semestral de 1991/92 (grupo INICIAL, n=153) ou 2001/02 (grupo ATUAL, n=154). Foram analisados características demográficas, doenças cardíacas, co-morbidades e eventos operatórios, visando à comparação entre grupos e definição do escore de risco de morte hospitalar (conforme Cleveland Clinic). RESULTADOS: O grupo ATUAL tinha idade mais avançada, condição cardíaca mais grave (classe funcional, prevalência de insuficiência cardíaca e número de vasos com lesão severa) e maior prevalência de co-morbidades. Os pacientes iniciais mostraram maior prevalência na indicação cirúrgica de urgência. Não ocorreu diferença no escore médio de risco calculado para ambos os grupos (2,8 + 3,1 no INICIAL e 2,2 + 2,5 no ATUAL) ou na mortalidade hospitalar (respectivamente 3,3% e 1,9%), valores comparáveis com os comunicados pela Cleveland Clinic (para escore de risco 3, mortalidade prevista de 2,0 %, com limite de confiança 95% de 0-4,3% e mortalidade real em estudo de confirmação de 3,4%). CONCLUSÃO: Pacientes atualmente submetidos a CRM são mais idosos e em pior condição clínica (cardíaca e sistêmica) que os operados há 10 anos, mas a pontuação no escore de risco e a mortalidade hospitalar foram discretamente aumentadas no grupo inicial. Para isto, pode ter contribuído maior prevalência de cirurgias de urgência. Um escore de risco pode ser utilizado para identificar pacientes que requerem maiores cuidados e predizer o resultado cirúrgico.OBJECTIVE: To compare clinical and surgical and clinical profiles of two group of patients submitted to Coronary Artery Bypass Graft (CABG) at Instituto de Cardiologia do RGS within a decade interval, define related hospital mortality and to validate a severity risk score for this populations. METHODS: Retrospective cohort study, including 307 CABG patients operated during six months of 1991/92 (n=153) and 2001/02 (n=154). Demographic characteristics, heart disease severity, co-morbidities and pre-operative events were evaluated and compared between groups. Hospital mortality and severity risk scores for mortality according to Cleveland Clinic were also assessed. RESULTS: Patients operated in 2001/02 were older, had more severe cardiac disease (increased NYHA functional class, prevalence of heart failure, and distribution of coronary diseased) and presented more co-morbidities than those operated in 1991/92. This patients required urgent surgery more often. The mean Cleveland Clinic severity risk score wasn't different between groups (2.8 + 3.1 in 1991/92 and 2.2 + 2.5 in 2001/02) and hospital mortality didn't present significant difference (3.3% and 1.9%, respectively). For Cleveland Clinic score 3 the predicted mortality was estimated as 2.0% (with confidence limit 95% of 0- 4.3%) and observed mortality for surgical patients of this institution was 3.4%. CONCLUSION: Patients submitted to CABG currently are older and in worse clinical conditions than those operated 10 years ago, but severity risk scores and hospital mortality were discretely increased for initial series of patients. This may be a consequent of a higher prevalence of urgent surgical indication in those patients. A severity risk score for hospital mortality can be used to predict surgical result and identify patients requiring specific care.

OBJETIVO: Nosso objetivo é apresentar resultados a longo prazo da subsituição valvar por bioprótese de pericárdio bovino SJM-BiocorTM. MÉTODO: Entre 1992 e 2000, tiveram alta hospitalar, após substituição valvar por bioprótese de pericárdio bovino SJM-BiocorTM 304 pacientes. Idades eram de 15 a 83 anos (média: 60,6±14,3), sendo 50,3% do sexo masculino. Pacientes tiveram situação clínica atualizada e análise atuarial foi empregada no cálculo da sobrevida simples e livre de eventos. RESULTADOS: Em um seguimento total de 931,0 pacientes-ano, ocorreram 28 (9,2%) óbitos tardios, sendo cinco (1,6%) relacionados à bioprótese, sete (2,3%) cardíacos, quatro (1,3%) não-cardíacos e 12 (3,9%) de causa desconhecida. Eventos de bioprótese foram: endocardite: 18 (5,9%), degeneração fibrocálcica: 15 (4,9%), tromboembolismo: três (1,0%), hemólise: um (0,3%). Disfunção de bioprótese resultou em 16 (5,2%) reoperações, por degeneração fibrocálcica (nove), endocardite (seis) e tromboembolismo (um). Probabilidade de sobrevida foi 86,3±3,4%, no 5º, e 69,3±9,0%, no 10º ano pós-operatório. Idade jovem (60 anos, n=187): 82,0±13,3% vs 58,8±13,6%, no 9º ano. Sobrevida livre de eventos foi 77,5±3,7%, no 5º, e 40,2±9,0%, no 10º ano. Probabilidade de falência estrutural de bioprótese foi 5%, no 5º ano, e 20%, no 10º; em aórticos, zero e 8%, respectivamente. A classe funcional (NYHA) atual é I para 88,5%, II para 9,1% e III para 2,4% dos pacientes. CONCLUSÃO: Implante de bioprótese de pericárdio bovino SJM-BiocorTM resulta em satisfatória perspectiva de sobrevida dos pacientes com doença valvar e apresenta baixa prevalência de disfunção de prótese.OBJECTIVE: The objective of this work is to present long-term results of valve replacement using SJM-BiocorTM bovine pericardial bioprostheses. METHODS: From 1992 to 2000, 304 patients were discharged from hospital after bioprosthesis implantation. Ages ranged from 15 to 83 years (mean: 60.6 ± 14.3 years) and 50.3% were male. Patient deaths and events related to bioprosthesis (infection, thromboembolism and structural failure) were considered for estimation of cumulative probability of survival and event-free survival. RESULTS: Total follow-up was 931.0 patients-year. During follow-up there were 28 (9.2%) deaths. Causes were bioprosthesis failure in five (1.6%), cardiac in seven (2.3%), non-cardiac in four (1.3%), and unknown in 12 (3.9%) patients. Events related to bioprosthesis were: endocarditis: 18 (5.9%), fibrocalcic degeneration: 15 (4.9%), thromboembolism: three (1.0%), hemolysis: one (0.3%). Bioprosthesis dysfunctions resulted in 16 (5.2%) reoperations due to fibrocalcic degeneration (nine), endocarditis (six) and thromboembolism (one). Probability of survival was higher in the young population (< 40 years, n=35) when compared to the older group (> 60 year, n=187): 82.0 ± 13.3% vs. 58.8 ± 13.6% in the 9th year. Event-free survival was 77.5 ± 3.7% for 5th year and 40.2 ± 9.0% for 10th year. Overall estimative of structural failure for a SJM-BiocorTM was 5% in 5th year increasing to 20% in the 10th year. In the aortic position the values were zero and 8%, respectively. Considering current clinical conditions, 88.5% are in NYHA class I, 9.1% in class II and 2.3% in class III. CONCLUSIONS: SJM-BiocorTM bovine pericardial bioprostheses resulted in satisfactory survival of patients, related to low prevalence of bioprosthesis dysfunction.

In Geodesy, the monitoring of sea level plays an important role in the realization of global reference systems and allows the integration of available data from classical vertical networks, whose Vertical Datum is usually defined by the Mean Sea Level (MSL), with different periods of observation and related to a specific epoch. The fact that each vertical datum is related to a defined epoch (the sea level is variable in space and time) associated with the leveling errors, produces significant differences in heights referred to different vertical nets; that shows the importance of the sea level monitoring. Usually, efforts must be done to recover old information and data. In this work, the main aspects related to the Brazilian Vertical Datum (BVD), its time evolution and the search of alternatives to determine this evolution are presented. Preliminary results, based in tide gauge and leveling data, have shown an increasing of the MSL at Imbituba harbor of about 2 mm/a, in the integration of time series stored at Permanent Service for Mean Sea Level (PSMSL) with recent digital data. This agrees with results of global sea level changes. Nowadays, satellite altimetry is an efficient way to monitor MSL variations. In this paper, are presented some results related with the comparison of satellite altimetry data and longer tide gauge temporal series, as those for Cananéia and Ilha Fiscal tide gauges, whose correlation coefficients are better than 0.8 among the series, in order to establish analysis methods applicable to BVD region.

OBJETIVO: Comparar resultados tardios da substituição valvar no anel aórtico com ou sem ampliação. MÉTODO: Incluídos 22 pacientes aórticos com ampliação anelar anterior e posterior por anel pequeno e 23 com diâmetro anelar normal quando da substituição valvar aórtica. Para grupos, foram comparáveis características como sexo, idade, diagnóstico valvar, etiologia da doença e lesões associadas. Substituição valvar simples foi rotineira. Para ampliação anelar posterior foi feita incisão no ponto médio do seio não coronariano, estendida ao folheto mitral anterior; ampliação anterior resultou de incisão no anel aórtico anterior, estendida por 2 cm no septo interventricular, não transfixado; reconstrução aórtica foi realizada por enxertos de pericárdio bovino. Resultados considerados para toda amostra foram características operatórias, evolução clínica (seguimento de 2 a 11 anos) e gradiente na via de saída do ventrículo esquerdo (VSVE) ao ecocardiograma Doppler. RESULTADOS: Ampliação aumentou diâmetro anelar aórtico de 18,3±2,2 mm para 24,8±2,0 mm (pOBJECTIVE: To compare results of aortic valve replacement in patients with normal valve annulus and in those requiring annular enlargement. METHOD: Study includes 22 patients submitted to anterior and posterior annulus enlargement and 23 patients with a normal aortic annulus. Both groups were matched in gender, age, valvar lesion, etiology of cardiac disease and associated lesions. Patients with normal annuli had usual valve replacement. For those who required annular enlargement, posterior enlargement was performed by incision in the mid portion of the non-coronary sinus up to the anterior mitral leaflet. Anterior enlargement resulted from an incision between left and right coronary ostia extended to the ventricular septum for 2 cm. The aorta was reconstructed using bovine pericardium patches. The diameter of aortic annulus at surgery, clinical evolution (2 to 11 years follow-up) and left outflow tract obstruction (Doppler echocardiography) were considered. RESULTS: Enlargement increased aortic annulus from 18.3±2.2 mm to 24.8±2.0 mm (p

A cirurgia robótica é hoje um método viável para reduzir o trauma e as morbidades relacionadas em cirurgia cardíaca. Em nossa instituição, o auxílio robótico já foi utilizado de forma bem-sucedida em implantes toracoscópicos de eletrodos epimiocárdicos para marcapassos biventriculares. O objetivo deste artigo é descrever a técnica por nós utilizada para dissecção da artéria torácica interna (ATI), mediante toracoscopia com apoio do robô AESOP e relatar seus resultados iniciais obtidos em nove pacientes.Robotic surgery is today a reliable method to reduce trauma and related comorbidities in cardiac surgery. In our institucion, robotic assistance has been effectively used for thoracoscopic implantation of epimyocardial leads for biventricular pacing. The objective of this article is to describe the technique that we developed to dissect the internal thoracic artery using thoracoscopy assistance with AESOP robotic system and to report the initial results obtained with its use in nine patients.

O desenvolvimento de sistemas robóticos para cirurgia teve início na década de 80, por solicitação do exército norte-americano, que antevia a possibilidade de realizar operações em teatros de guerra, distantes do local onde estava o cirurgião. Entretanto, o primeiro uso em humanos só ocorreu anos mais tarde, numa ressecção transuretral de hiperplasia benigna de próstata. Cirurgiões cardíacos foram logo atraídos pela técnica robótica devido a possível aplicação com reduzido caráter invasivo; esperava-se menor trauma cirúrgico e redução da dor, morbidade, tempo de internação e custo do procedimento. Atualmente, de forma restrita e em casos selecionados, robôs são usados para revascularização do miocárdio e implante de marcapasso em cirurgias cardíacas totalmente endoscópicas; podendo também constituir apoio visual na retirada de artéria torácica interna, reconstrução valvar mitral e correção de defeitos congênitos. Utilizando o robô auxiliar AESOP® para controle do videotoracoscópio, com controle vocal por meio do sistema HERMES®, temos realizado dissecção da artéria torácica interna, implante de eletrodo ventricular esquerdo e abordagem de defeitos congênitos na cirurgia de correção. Apesar do entusiasmo científico inicial com a cirurgia robótica, ainda não existe evidência clara de superioridade desta técnica em relação à operação convencional, em termos de resultado. Isto se aplica também ao custo, pois o investimento inicial na aquisição de sistema cirúrgico completo (console, controle de vídeo, instrumental) provavelmente é compensado após muitos procedimentos e longo intervalo. Mas é certo que a cirurgia robótica terá um lugar no futuro, possibilitando aprendizagem, telepresença e realização de procedimentos pouco invasivos, embora complexos.The development of robotic systems for surgery started in the 80's, motivated by the US army's need for surgical procedure in field hospitals with surgeons in a distant location (tele-presence). But the first human application of robotic surgery occurred years later in a transurethral resection for benign prostatic hyperplasia. Cardiac surgeons were attracted to the robotic techniques because of the potential reduction in the invasive character of the procedures. This results in reduced trauma, a reduction of pain and morbidity, a faster recovery and lower cost of surgery. Robotic systems were developed, allowing totally thoracoscopic cardiac surgery for myocardial revascularization and multi-site pacemaker implantation in selected cases. Video-thoracoscopic support systems for internal thoracic artery harvesting, mitral valve reconstruction and correction of congenital heart defects also exist. We used the AESOP® system with HERMES® voice control to harvest the internal thoracic artery, trans-thoracic implantation of the left ventricular electrode and as an approach to congenital heart defects for surgical repair. In spite of scientific enthusiasm related to robotic surgery, there is no clear evidence of superiority of this technique when compared to conventional procedures in terms of results. The same is true with the cost of the procedures, and even if a single robotic surgery is less expensive, the initial investment for a complete robotic system (console, video control, instruments) can be compensated only with many procedures over the long term. But there is no doubt that robotic surgery will have a place in the future of surgery, providing tele-presence of the surgeon, enabling teaching and training and performing less invasive surgical procedures.

OBJECTIVES: To study the influence of geometric factors upon the function of modified Blalock-Taussig anastomoses (mBT) using a computational dynamic code based upon the method of finite elements. METHODS: The mBT operation, performed in 10 patients, was graphically reconstructed to create a parametric 3-dimensional geometric model. Using Streamline Upwind/Petrov-Galerkin approximations, blood flow and distribution were evaluated in different diameters of subclavian arteries and polytetrafluoroethylene grafts (PTFE) and angles of proximal anastomoses. RESULTS: The percentage of blood flow derived through the PTFE grows as its diameter increases in relation to subclavian artery diameter. Variations in the PTFE diameter do not interfere with pulmonary artery flow distribution. An angle of 110º in proximal anastomoses results in a high percentage of blood derivation to the graft, while angles of 30º, 60ºand 90º present with almost similar flow rates. However, angles of 30º and 110º produce an excessive flow to one of the pulmonary arteries, in detriment of the other. Peak pressure in the PTFE is affected by the proximal angle of anastomosis, with 30º resulting in higher and 110º in lower values. As the angle increases, the region of higher pressure shifts from the PTFE to subclavian artery. CONCLUSION: In the experimental model, percentage of flow derived in the PTFE is directly related to the diameter of the graft. The ratio between the diameters of subclavian artery and graft is an important regulator of flow deviation to the anastomosis. Angles of the anastomosis between the subclavian artery and the PTFE of 60º to 90º result in favorable pulmonary artery flow distribution and the location of the peak pressure.OBJETIVO: Dinâmica computacional foi utilizada para avaliar a influência de fatores geométricos no funcionamento de modelo da cirurgia de Blalock-Taussig modificada (BTm), ou interposição de enxerto de politetrafluoretileno (PTFE) entre as artérias subclávia e pulmonar. MÉTODO: A cirurgia de BTm, realizada em 10 pacientes, serviu para compor modelo geométrico tridimensional parametrizado, avaliado quanto a diferentes diâmetros de artéria subclávia e PTFE e ângulo proximal da anastomose. Foi empregado o código de dinâmica computacional FLOTRAN baseado no método de elementos finitos conhecido como "Streamline Upwind/Petrov-Galerkin". RESULTADOS: Nas simulações, a porcentagem de fluxo desviada pelo enxerto aumenta com a relação entre diâmetros do PTFE e da artéria subclávia. Um ângulo de 110º na anastomose proximal mostra maior porcentagem de sangue desviado, enquanto que 30º, 60º e 90º mostram desvios de fluxo quase similares. Contudo, ângulos de 30º e 110º tornam excessivo o fluxo pulmonar em uma das artérias pulmonares, em detrimento da outra. O pico de pressão no PTFE varia conforme o ângulo adotado, sendo maior em 30º . Quando o ângulo da anastomose aumenta, a região de maior pressão se desloca do enxerto para a artéria subclávia. CONCLUSÕES: No modelo experimental, o diâmetro do enxerto de PTFE é regulador principal da porcentagem de fluxo desviado. Na análise computadorizada, um ângulo de 60º a 90º entre artéria subclávia e enxerto de PTFE parece mais adequado para anastomose, considerando-se percentagem de fluxo desviado, sua distribuição entre ramos pulmonares e pico de pressão na zona da anastomose.

OBJECTIVE: Evaluate coronary angiogenic response to transmural injection of plasmid encoding VEGF 165 in acute myocardial infarction (AMI) zones in a canine model. METHODS: The heart of eleven dogs was exposed and AMI was induced by occlusion of the diagonal branch of anterior descending coronary artery. For each of 10 selected points in the infarction area and its peripheral zone injections of 1 ml of saline solution (control group: five dogs) or 1 ml of plasmid encoding VEGF 165 solution (200 µg/ml) (VEGF group: six dogs) were introduced. Tecnecium myocardial scintigraphy was performed immediately after animal recovery and 14 days later to evaluate the myocardial perfusion. The animals were sacrificed and the hearts were submitted to a histological study of the infarcted area, peripheral zone and normal posterior ventricular wall, to evaluate the number of arterioles and capillaries. RESULTS: Immediate modifications in myocardial perfusion found in scintigraphic studies were similar in both groups. In the second evaluation at 14 days, hypoperfusion of ischemic area had recovered by 70% to 90% when compared to the day of AMI. Histologic evaluation of the peripheral area of AMI indicated a larger number of vessels in the VEGF group when compared to controls (mean: 123.81 + 21.48 and 40 + 6.13, p < 0.01, respectively). This increase resulted mainly from an increase in the number of capillaries (97.5 + 16.04 in the VEGF group and 22.18 + 3,25 in control group, p < 0.01), as the number of arterioles did not increase significantly. In the VEGF group, a comparison in the number of vessels of the AMI peripheral area and normal myocardium revealed a non-significant increase of vessels in the ischemic area (123.81 + 21.48 and 95.14 + 41.19). CONCLUSION: An intramural injection of plasmid VEGF 165 resulted in a significant increase in the number of capillaries in the peripheral AMI area. This increase may have a beneficial effect in the reduction and recovery of the ischemic area secondary to AMI.OBJETIVO: Verificar a indução de angiogênese miocárdica pela injeção transmural de plasmídeo VEGF 165 (Genentech/ USA) em zonas do infarto agudo do miocárdio (IAM) de cães, mediante avaliação por cintilografia miocárdica e estudo histológico. MÉTODOS: Em onze cães anestesiados o coração foi abordado em toracotomia antero-lateral esquerda e produzido IAM pela ligadura simples de ramo diagonal da artéria coronária descendente anterior. Em cada de 10 pontos selecionados da área infartada e sua periferia foi realizada a injeção de um total de 1 ml de solução salina (grupo controle: cinco cães) ou de solução contendo plasmídeo VEGF 165 na concentração de 200 ug/ml (grupo tratado: seis cães). Os animais foram recuperados e realizada cintilografia miocárdica com Tecnécio imediatamente e 14 dias após IAM. Os animais foram sacrificados e o coração retirado para estudo histológico da área de infarto, de sua periferia e de área da parede ventricular posterior, visando contagem eletrônica de capilares e arteríolas. RESULTADOS: Cintilografia mostrou modificações na perfusão miocárdica comparáveis entre os grupos quanto ao estudo imediato e 15 dias após IAM, sendo que os dois grupos mostraram uma recuperação de 70 a 90 % da hipoperfusão demonstrada no 1o exame. O estudo histológico da área de transição do IAM revelou um maior número de vasos no grupo tratado em relação ao grupo controle (média de 123,81 + 21,48 e 40 + 6,13, respectivamente; p 0,05). CONCLUSÕES: Injeção transmural de plasmídeo VEGF 165 resultou em significativo aumento no número de capilares na zona de transição do IAM experimental. O aumento de capilares pela terapia gênica tem presumível efeito benéfico na redução e recuperação da área isquêmica.

This study focuses on the substantive area of commitment to service in the community of educational partners in the Philippines. Educational partners are lay people who assist religious organizations in the field of education, and in the Philippines, about 96 percent of educational partners are in Lasallian schools and organizations. Educational partners are young professionals, volunteers between the ages of 24-39 who strive to live the teachings of St. John Baptist De La Salle. The volunteers aim to generate a spirit of service, a sense of mission to the youth. By using a classic Grounded Theory approach, the theory of becoming selfless was generated. The theory explains the stages educational partners undergo when resolving their organizational commitment to service. Organizational commitment is the psychological attachment, involvement and identification of the individual to the organization. Becoming selfless provides a theoretical focal point to better understand the complexity of commitment.

This paper describes the methodology used in the Masters of Bilingual Education at Nebrija University highlighting the blended learning method. The authors present and describe the different instruments used to provide students with effective opportunities in learning the content and foreign language.

Bone marrow mononuclear cells (BMMC) effects have been investigated in small series of nonischemic dilated cardiomyopathy (NIDC). Left ventricular myocardial contractility improvements occur, but doubt remains about their mechanism of action. We compared contractility changes in areas treated (free wall) and nontreated (septal wall) with BMMC, in selected patients who have showed significant ventricular improvement after free wall-only intramyocardial stem cells injection. From 15 patients with functional class III/IV (NYHA) and LVEF inferior to 35%, who received 9.6 ± 2.6 × 10 7 BMMC divided into 10 points over the left ventricular free wall, 7 (46.7%) showed LVEF relative improvement greater than 15%. Those patients were selected for further contractility study. BMMC were collected from iliac bone and isolated with Ficoll-Hypaque. Magnetic resonance imaging was used to measure the systolic thickening of the septal (nontreated) and free wall (treated) before injection and 3 months postoperatively. Mean systolic septal wall thickening increased from 0.46 to 1.23 mm (an absolute 0.77 ± 1.3 mm and relative 167.4% increase) and in the free wall from 1.13 to 1.87 mm (an absolute 0.74 ± 1.5 mm and relative increase of 65.5%). There was no difference in the rate of absolute or relative systolic thickening between the two walls ( p = 0.866 and 1.0, respectively), when cells were injected only in the left ventricular free wall. BMMC transplantation in nonischemic dilated cardiomyopathy can improve ventricular function by an overall effect, even in areas that are not directly injected. This finding favors the existence of a diffuse mechanism of action, rather than a local effect, and should be reminded when the pathophysiology of stem cells is considered.

Foi realizado um estudo comparativo da reação de imunofluorescência indireta em eluatos de sangue de cães infectados experimentalmente com diferentes tripanosomatídeos. Utilizaram-se como antigenopromastigotas de L. mexicana, L. braziliensis e L. chagasi. Os resultados mostraram que a sensibilidade do método foi de 87,5% para o diagnóstico do calazar canino, independentemente do antigeno empregado; e que ocorre reação cruzada com Leishmaniose tegumentar em 75% dos casos e com doença de Chagas em 83,3%. Levantamento epidemiológico em área de leishmaniose confirma que a reação de imunofluorescência em eluatos de sangue canino fornece reações cruzadas em cães infectados com Leishmania braziliensis e L. chagasi. Não se verificou reação cruzada pela RFC. Sugere-se a utilização da reação de imunofluorescência nas campanhas de saúde pública, mas é de se chamar a atenção para o fato de que as taxas de positividade não devem ser utilizadas como indicadores da prevalência do calazar canino.

Objetivo: Quando o implante de eletrodo de seio coronário para a estimulaçao biventricular é impraticável, técnicas alternativas sao consideradas, entre elas o implante epimiocárdio do eletrodo ventricular esquerdo mediante toracotomia. Visando reduzir o trauma da toracotomia, desenvolvemos a técnica de implante toracoscópico do eletrodo com assistência robótica, procedimento realizado em três pacientes com miocardiopatia dilatada e insuficiência cardíaca severa. Métodos: No implante toracoscópico do eletrodo, 3 trocateres foram colocados no tórax esquerdo e utilizados para instrumentaçao, introduçao do eletrodo e posicionamento do endoscópio manipulado por robô (modelo AESOP, Computer Motion, EUA). O pericárdio foi aberto e o eletrodo epicárdico sem sutura ELC 54-UP (Biotronik, Alemanha) foi fixado na parede lateral do ventrículo esquerdo. Sua extremidade proximal foi passada à regiao peitoral, em que haviam sido introduzidos eletrodos transvenosos atrial e ventricular direito. Os eletrodos foram conectados a um gerador multicameral de pulsos. Os pacientes foram extubados após o procedimento e tiveram alta da sala de recuperaçao em menos de 12 horas. A avaliaçao do implante ocorreu durante cirurgia e um mês após. Resultados: as avaliaçoes eletrofisiológicas do eletrodo ventricular esquerdo foram satisfatórias. A estimulaçao biventricular ocorreu nos pacientes durante o período estudado, embora um deles apresentasse arritmia supraventricular, o que impossibilitou um efeito hemodinâmico consistente. Conclusoes: O implante de eletrodo ventricular esquerdo mediante toracoscopia assistida por robô foi realizado com sucesso e minimizou o trauma cirúrgico. Resultados satisfatórios foram observados a curto prazo, sendo necessário um acompanhamento mais prolongado para confirmar a eficácia da técnica.