RESUMO
Approaches to managing inland fisheries vary between systems and regions but are often based on large-scale marine fisheries principles and thus limited and outdated. Rarely do they adopt holistic approaches that consider the complex interplay among humans, fish, and the environment. We argue that there is an urgent need for a shift in inland fisheries management towards holistic and transdisciplinary approaches that embrace the principles of social-ecological systems at the watershed scale. The interconnectedness of inland fisheries with their associated watershed (biotic, abiotic, and humans) make them extremely complex and challenging to manage and protect. For this reason, the watershed is a logical management unit. To assist management at this scale, we propose a framework that integrates disparate concepts and management paradigms to facilitate inland fisheries management and sustainability. We contend that inland fisheries need to be managed as social-ecological watershed system (SEWS). The framework supports watershed-scale and transboundary governance to manage inland fisheries, and transdisciplinary projects and teams to ensure relevant and applicable monitoring and research. We discuss concepts of social-ecological feedback and interactions of multiple stressors and factors within/between the social-ecological systems. Moreover, we emphasize that management, monitoring, and research on inland fisheries at the watershed scale are needed to ensure long-term sustainable and resilient fisheries.
Assuntos
Ecossistema , Pesqueiros , Meio Social , Animais , Conservação dos Recursos Naturais , Pesqueiros/organização & administração , Peixes , Humanos , PesquisaRESUMO
Inland recreational fishing is primarily considered a leisure-driven activity in freshwaters, yet its harvest can contribute to food systems. Here we estimate that the harvest from inland recreational fishing equates to just over one-tenth of all reported inland fisheries catch globally. The estimated total consumptive use value of inland recreational fish destined for human consumption may reach US$9.95 billion annually. We identify Austria, Canada, Germany and Slovakia as countries above the third quantile for nutrition, economic value and climate vulnerability. These results have important implications for populations dependent on inland recreational fishing for food. Our findings can inform climate adaptation planning for inland recreational fisheries, particularly those not currently managed as food fisheries.
Assuntos
Mudança Climática , Pesqueiros , Valor Nutritivo , Recreação , Mudança Climática/economia , Pesqueiros/economia , Humanos , Animais , Peixes , Canadá , Alemanha , Áustria , Eslováquia , Conservação dos Recursos Naturais/economia , Água DoceRESUMO
Generating awareness of environmental conservation issues among the public is essential if there is an expectation of them to alter their behaviour, facilitate informed decisions and engage governments or regulatory authorities to take action. There are, however, exceedingly few public engagement success stories related to inland fishes and fisheries policy and resource allocation decisions. Inland aquatic resources and their associated fisheries provide employment, recreation, culture and, in developing regions, a considerable proportion of human nutrition and food security. Freshwater fishes are incredibly diverse but are among the most endangered organisms globally. Many threats to inland fisheries are driven largely by externalities to inland fisheries. The purpose of this paper is to draw attention to the role and plight of inland fishes and fisheries, and the need to generate the public and political will necessary to promote meaningful conservation. With this paper, the extent to which the scientific and environmental management communities have failed to engage the public in issues related to inland fishes and fisheries is characterized. Next, the barriers or factors that serve as the basis for the problem with public engagement are identified. The paper concludes by identifying strategies, including those focused on environmental education initiatives, for building the public and political will necessary to promote meaningful conservation of inland fishes and fisheries in developed and developing countries. Scientists, environmental managers, non-governmental organizations, politicians, regulatory authorities and the media all have important roles to play in overcoming challenges to inland fisheries. Failure to engage the public in freshwater conservation and management issues will impede efforts to stem the loss of freshwater habitats, fisheries and aquatic biodiversity. Thankfully, there are opportunities to learn from success stories related to other environmental issues and initiatives that have been successful in marine fish conservation.
Assuntos
Participação da Comunidade , Conservação dos Recursos Naturais/legislação & jurisprudência , Política Ambiental , Pesqueiros/legislação & jurisprudência , Animais , Comunicação , Peixes , Água DoceRESUMO
Inland recreational fisheries, found in lakes, rivers, and other landlocked waters, are important to livelihoods, nutrition, leisure, and other societal ecosystem services worldwide. Although recreationally-caught fish are frequently harvested and consumed by fishers, their contribution to food and nutrition has not been adequately quantified due to lack of data, poor monitoring, and under-reporting, especially in developing countries. Beyond limited global harvest estimates, few have explored species-specific harvest patterns, although this variability has implications for fisheries management and food security. Given the continued growth of the recreational fishery sector, understanding inland recreational fish harvest and consumption rates represents a critical knowledge gap. Based on a comprehensive literature search and expert knowledge review, we quantified multiple aspects of global inland recreational fisheries for 81 countries spanning ~192 species. For each country, we assembled recreational fishing participation rate and estimated species-specific harvest and consumption rate. This dataset provides a foundation for future assessments, including understanding nutritional and economic contributions of inland recreational fisheries.
Assuntos
Pesqueiros , Animais , Conservação dos Recursos Naturais , Ecossistema , Peixes , Especificidade da EspécieRESUMO
Inland fisheries are a vital component in the livelihoods and food security of people throughout the world, as well as contributing huge recreational and economic benefits. These valuable assets are jeopardized by lack of research-based understanding of the impacts of fisheries on inland ecosystems, and similarly the impact of human activities associated with inland waters on fisheries and aquatic biodiversity. To explore this topic, an international workshop was organized in order to examine strategies to incorporate fisheries into ecosystem approaches for management of inland waters. To achieve this goal, a new research agenda is needed that focuses on: quantifying the ecosystem services provided by fresh waters; quantifying the economic, social and nutritional benefits of inland fisheries; improving assessments designed to evaluate fisheries exploitation potential; and examining feedbacks between fisheries, ecosystem productivity and aquatic biodiversity. Accomplishing these objectives will require merging natural and social science approaches to address coupled social-ecological system dynamics.
Assuntos
Ecossistema , Pesqueiros , Animais , Biodiversidade , Pesqueiros/economia , PesquisaRESUMO
Inland fisheries and their freshwater habitats face intensifying effects from multiple natural and anthropogenic pressures. Fish harvest and biodiversity data remain largely disparate and severely deficient in many areas, which makes assessing and managing inland fisheries difficult. Expert knowledge is increasingly used to improve and inform biological or vulnerability assessments, especially in data-poor areas. Integrating expert knowledge on the distribution, intensity, and relative influence of human activities can guide natural resource management strategies and institutional resource allocation and prioritization. This paper introduces a dataset summarizing the expert-perceived state of inland fisheries at the basin (fishery) level. An electronic survey distributed to professional networks (June-September 2020) captured expert perceptions (n = 536) of threats, successes, and adaptive capacity to fisheries across 93 hydrological basins, 79 countries, and all major freshwater habitat types. This dataset can be used to address research questions with conservation relevance, including: demographic influences on perceptions of threat, adaptive capacities for climate change, external factors driving multi-stressor interactions, and geospatial threat assessments.
Assuntos
Pesqueiros , Peixes , Animais , Mudança Climática , Conservação dos Recursos Naturais , Atividades Humanas , Humanos , ConhecimentoRESUMO
Globally, our knowledge on lake fisheries is still limited despite their importance to food security and livelihoods. Here we show that fish catches can respond either positively or negatively to climate and land-use changes, by analyzing time-series data (1970-2014) for 31 lakes across five continents. We find that effects of a climate or land-use driver (e.g., air temperature) on lake environment could be relatively consistent in directions, but consequential changes in a lake-environmental factor (e.g., water temperature) could result in either increases or decreases in fish catch in a given lake. A subsequent correlation analysis indicates that reductions in fish catch was less likely to occur in response to potential climate and land-use changes if a lake is located in a region with greater access to clean water. This finding suggests that adequate investments for water-quality protection and water-use efficiency can provide additional benefits to lake fisheries and food security.
Assuntos
Pesqueiros , Lagos/química , Animais , Mudança Climática , Ecossistema , Peixes/crescimento & desenvolvimento , Humanos , Temperatura , Qualidade da ÁguaRESUMO
At present, inland fisheries are not often a national or regional governance priority and as a result, inland capture fisheries are undervalued and largely overlooked. As such they are threatened in both developing and developed countries. Indeed, due to lack of reliable data, inland fisheries have never been part of any high profile global fisheries assessment and are notably absent from the Sustainable Development Goals. The general public and policy makers are largely ignorant of the plight of freshwater ecosystems and the fish they support, as well as the ecosystem services generated by inland fisheries. This ignorance is particularly salient given that the current emphasis on the food-water-energy nexus often fails to include the important role that inland fish and fisheries play in food security and supporting livelihoods in low-income food deficit countries. Developing countries in Africa and Asia produce about 11 million tonnes of inland fish annually, 90 % of the global total. The role of inland fisheries goes beyond just kilocalories; fish provide important micronutrients and essentially fatty acids. In some regions, inland recreational fisheries are important, generating much wealth and supporting livelihoods. The following three key recommendations are necessary for action if inland fisheries are to become a part of the food-water-energy discussion: invest in improved valuation and assessment methods, build better methods to effectively govern inland fisheries (requires capacity building and incentives), and develop approaches to managing waters across sectors and scales. Moreover, if inland fisheries are recognized as important to food security, livelihoods, and human well-being, they can be more easily incorporated in regional, national, and global policies and agreements on water issues. Through these approaches, inland fisheries can be better evaluated and be more fully recognized in broader water resource and aquatic ecosystem planning and decision-making frameworks, enhancing their value and sustainability for the future.
Assuntos
Conservação dos Recursos Naturais/tendências , Política Ambiental , Pesqueiros/organização & administração , Pesqueiros/tendências , Animais , Participação da Comunidade , Conservação dos Recursos Naturais/legislação & jurisprudência , Ecossistema , Política Ambiental/legislação & jurisprudência , Política Ambiental/tendências , Pesqueiros/legislação & jurisprudência , Peixes/crescimento & desenvolvimentoRESUMO
OBJECTIVES: To measure the associations among blood pressure, hypertension, and recorded dietary factors. METHODS: Data were analyzed from the computer file of the Dietary and Nutritional Survey of British Adults, in which persons of both sexes aged 16 to 64 years living in private households (excluding pregnant women) had been randomly selected from the United Kingdom Electoral Register. Main outcome measures were systolic blood pressure, diastolic blood pressure, and hypertension (defined as systolic blood pressure of > or = 140 mm Hg, diastolic blood pressure of > or = 90 mm Hg, or both, or receiving antihypertensive medication). RESULTS: After controlling for 24-hour urinary potassium excretion, age, obesity, alcohol intake, and season of interview, a single measure of 24-hour urinary sodium excretion was significantly associated with systolic blood pressure (P < or = .001), diastolic blood pressure (P < .05), and hypertension (P = .009). These associations persisted after controlling for many variables of blood chemistry and dietary intake. CONCLUSIONS: Sodium is positively associated with blood pressure over a range of sodium excretion rates from 70 to 400 mmol/d. This finding supports the international consensus that the risk of hypertension is lower when salt intake is lower and suggests that a proportion of the British population has a sodium excretion rate that is habitually low enough to have some preventive effect.
Assuntos
Pressão Sanguínea , Dieta , Adulto , Feminino , Humanos , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Análise de Regressão , Reino UnidoRESUMO
In a recent edition of this journal Mikael Bask and Maria Melkersson suggested that moist snuff, snus to the Swedes, is not an effective tool in cigarette smoking cessation. The sole basis for this conclusion is their empirical findings concerning the cross-price elasticity of demand between cigarettes and snus. Specifically, they find that, "The cross-price elasticities are negative, which indicates that snus contributes to increased smoking. Thus, even if snus taking is less harmful than cigarette smoking, it is not advisable to encourage its use in smoking cessation programs." We find this conclusion to be unwarranted. It is based on a model estimated with inappropriate data; it is based on a misspecified model with questionable theoretical underpinnings; and no evidence is presented as to the statistical significance of the cross-price effects. Furthermore, even if we ignore these technical criticisms, their conclusions are unfounded because they are based on an inappropriate conceptual experiment. We first address some technical problems with the Bask and Melkersson analysis, and then we address the fundamental flaw in their reasoning.
Assuntos
Abandono do Hábito de Fumar/economia , Tabaco sem Fumaça/economia , Humanos , Abandono do Hábito de Fumar/métodos , SuéciaRESUMO
Amiodarone (AD) and its major metabolite, desethylamiodarone (desethylAD), are both phospholipogenic. The present study was undertaken to evaluate the comparative susceptibilities of male Fischer-344 and Sprague-Dawley rats to AD-induced phospholipidosis in alveolar macrophages (AMs), liver and kidney tissue and the concomitant accumulation of AD and desethylAD in these cells, tissues and plasma. Rats were administered AD (100 mg/kg/day, p.o.) for 1 week. Plasma concentrations of AD and desethylAD were approximately 4- and 12-fold higher, respectively, in Fischer-344s compared to Sprague-Dawleys 24 h after the last dose. AD and desethylAD levels in AMs were approximately 12- and 25-fold higher, respectively, in Fischer-344s than Sprague-Dawleys. In the liver and kidney, levels of both compounds were also significantly higher in Fischer-344s than Sprague-Dawleys. Ultrastructural features indicative of phospholipidosis were not observed consistently in any tissue except AMs from treated Fischer-344s. AM total phospholipid increased nearly 5-fold in Fischer-344s, while Sprague-Dawleys showed no increase over control. AMs from both strains incubated with 10 microM AD or desethylAD in vitro were not significantly different in their accumulation of the compounds. When incubated with AD or desethylAD, the lysosomal phospholipases A1 partially purified from AMs of both strains were equally sensitive to inhibition as measured by the drug concentration giving 50% inhibition in activity (IC50). The results of this study indicate that at the same administered dose, AD and desethylAD, accumulate to higher tissue levels and are more phospholipogenic in male Fischer-344 rats than in male Sprague-Dawley rats. The basis for the high susceptibility of Fischer-344 rats to AM-induced phospholipidosis is unknown at present but appears not to be related to biochemical or cellular features of the AMs.
Assuntos
Amiodarona/metabolismo , Amiodarona/toxicidade , Antiarrítmicos/toxicidade , Lipidoses/induzido quimicamente , Fosfolipídeos/metabolismo , Amiodarona/análogos & derivados , Amiodarona/sangue , Animais , Antiarrítmicos/metabolismo , Células Cultivadas , Rim/metabolismo , Fígado/metabolismo , Macrófagos Alveolares/química , Macrófagos Alveolares/metabolismo , Macrófagos Alveolares/ultraestrutura , Masculino , Fosfolipases A/antagonistas & inibidores , Fosfolipases A/metabolismo , Fosfolipídeos/análise , Ratos , Ratos Endogâmicos F344 , Ratos Sprague-DawleyRESUMO
OBJECTIVE: To explore the relationship between urinary sodium (the best measure of salt intake), urinary calcium, urinary deoxypyridinoline (DPYR) and bone mass. DESIGN: Cross-sectional study. SETTING: Population based sample of healthy Hobart residents. SUBJECTS: One hundred and fifty-four (M = 34, F = 120) subjects invited to take part from a systematic sample of the electoral roll and a single newspaper advertisement. RESULTS: In both sexes, urinary sodium correlated moderately with urinary DPYR (r = 0.32, P < 0.0001) and urinary calcium (r = 0.37, P < 0.0001). In multivariate analysis, the combination of urinary sodium, total body bone area, age and sex explained 22% of the variation in log-transformed DPYR (P < 0.00001). In univariate analysis, both urinary sodium and urinary DPYR were strongly associated with bone mineral content and bone mineral density at all sites but this association disappeared after adjustment for confounders particularly body weight. CONCLUSIONS: This study has shown that salt intake is associated with markers of bone resorption in a population-based sample of males and females and appears likely to be a risk factor for osteoporosis despite the lack of a demonstrable association between bone mass and a single measure of urinary sodium excretion. Further studies are needed to define the effect of salt intake on bone mass and fractures more clearly. These studies will need to be either longitudinal or interventional in design with repeated measures of urinary sodium so that habitual sodium intake can be accurately assessed and regression dilution bias can be minimised.
Assuntos
Aminoácidos/urina , Densidade Óssea/fisiologia , Reabsorção Óssea/etiologia , Cálcio/urina , Osteoporose/etiologia , Cloreto de Sódio na Dieta/urina , Adulto , Aminoácidos/análise , Aminoácidos/metabolismo , Peso Corporal , Reabsorção Óssea/urina , Cálcio/análise , Cálcio/metabolismo , Creatinina/análise , Creatinina/metabolismo , Creatinina/urina , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Cloreto de Sódio na Dieta/administração & dosagem , Cloreto de Sódio na Dieta/metabolismoRESUMO
OBJECTIVE: : To ascertain (1) whether the taste characteristics of a conventionally-salted (150 mM NaCl) soup can be reproduced in soups of substantially lower NaCl level with the help of added glutamate, and (2) whether calcium diglutamate (CDG) is equivalent to monosodium glutamate (MSG) in its effect on the taste of soup. DESIGN: : Cross-sectional, with multiple measurements on each subject. SETTING: : Healthy university students. SUBJECTS: : A total of 107 volunteers, recruited by on-campus advertising. METHODS: : Subjects tasted 32 soups, with all possible combinations of four NaCl concentrations (0-150 mM), four glutamate levels (0-43 mM), and two glutamate types (MSG, CDG). MAIN OUTCOME MEASURES: : Ratings of each soup on six scales (liking, flavour-intensity, familiarity, naturalness of taste, richness of taste, saltiness). RESULTS: : A 50 or 85 mM NaCl soup with added CDG or MSG is rated as high as, or higher than, a 150 mM NaCl soup free of added glutamate on five of the six scales (the exception being saltiness). CDG and MSG have equivalent effects. CONCLUSIONS: : Addition of glutamate allows substantial reductions in Na content of soup, without significant deterioration of taste. CDG and MSG have equivalent effects, but use of CDG permits a greater reduction in Na intake.
Assuntos
Aditivos Alimentares/administração & dosagem , Ácido Glutâmico/farmacologia , Cloreto de Sódio/farmacologia , Glutamato de Sódio/administração & dosagem , Paladar/fisiologia , Adulto , Estudos Transversais , Dieta Hipossódica , Feminino , Ácido Glutâmico/administração & dosagem , Humanos , Masculino , Cloreto de Sódio/administração & dosagemRESUMO
Thirty out of 287 patients (10.4%) admitted to hospital for infective endocarditis between December 1970 and January 1990 had neurological complications. Twenty-three patients had native valve infectious endocarditis and 7 had prosthetic valve endocarditis. The clinical features were characterized by the frequency of aortic valve involvement (23 out of 30) and other complications, especially cardiac failure (16 cases) and peripheral vascular manifestations (7 cases). The commonest organism was the staphylococcus (53% of identified organisms) but the number of negative blood cultures was high (50% of cases). The neurological complication was often the presenting symptom of the endocarditis (19 cases) but it occurred after bacteriological cure in 4 cases. The complications observed were cerebral ischemia (16 cases), cerebral haemorrhage (11 cases), coma (2 cases), and one peripheral neuropathy causing a Claude Bernard Horner syndrome. These complications presented with hemiplegia in 17 cases, a meningeal syndrome in 8 cases, a convulsion in 1 case, a Von Wallenberg syndrome in 1 case, and a Claude Bernard Horner syndrome in 1 case. Twelve patients had a transient or permanent neurological coma. Cerebral CT scan showed ischemic lesions in 7 cases and haemorrhagic lesions in 10 cases. Carotid angiography demonstrated mycotic aneurysms in 6 patients. Twelve patients died: the cause of death was neurological coma (7 cases), low cardiac output (4 cases) and haemorrhagic shock (1 case). Four patients underwent neurosurgery: 3 for clipping a mycotic aneurysm and 1 for drainage of an intracerebral haematoma. Poor prognostic factors were: coma, cardiac failure, cardiac valve prosthesis and, above all, the extent and multiplicity of the neurological lesions. The authors propose the following measures to improve the prognosis: early surgery in cases of large and/or mobile vegetations especially when the infecting organism is a staphylococcus and when a systemic embolism has occurred; routine CT scanning and/or digitised cerebral angiography in all patients with infective endocarditis to detect surgically accessible mycotic aneurysms.
Assuntos
Endocardite Bacteriana/complicações , Doenças do Sistema Nervoso/etiologia , Infecções Estafilocócicas/complicações , Adolescente , Adulto , Aneurisma Infectado/etiologia , Isquemia Encefálica/etiologia , Angiografia Cerebral , Hemorragia Cerebral/etiologia , Criança , Pré-Escolar , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/cirurgia , Feminino , Próteses Valvulares Cardíacas , Síndrome de Horner/etiologia , Humanos , Aneurisma Intracraniano/etiologia , Masculino , Doenças do Sistema Nervoso/diagnóstico por imagem , Prognóstico , Técnica de Subtração , Tomografia Computadorizada por Raios XRESUMO
Three hundred and twenty eight patients (238 men, 90 women) with an average age of 63.5 +/- 18 years admitted consecutively for acute myocardial infarction over a 24 month period (March 1989-March 1991) were followed up at one year by out-patient appointment, questionnaire or telephonic enquiry. The average delay before hospital admission was 6.7 +/- 44 hours (1 h-48 h). The infarct was transmural in 82% of cases, anterior in 45.3%, inferior in 46.3% and lateral in 8.4% of cases. Forty eight per cent had one or several complications during the hospital period with a 10.4% hospital mortality rate. Thirty eight per cent of patients underwent primary thrombolysis and 9% had primary angioplasty. Seventy four per cent of patients had coronary angiography; 41% underwent deferred angioplasty and 6% surgical revascularisation. The global 1 year survival rate was 81.4%. At follow-up, 52.6% of patients were asymptomatic, 31% had signs of cardiac failure and 18% had residual angina. Sixty five per cent were treated with 2 or 3 drugs; 6% underwent secondary angioplasty and 2.8% secondary coronary bypass surgery. Of the 34% of active subjects, 61.4% declared having returned to full-time professional activity. Therefore, in 1992, a continuous reduction of infarct-related mortality and morbidity was observed.
Assuntos
Infarto do Miocárdio/mortalidade , Análise Atuarial , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Angioplastia Coronária com Balão , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/terapia , Taxa de Sobrevida , Terapia TrombolíticaRESUMO
The isoforms of creatinine kinase (CK) and myoglobin were analysed by serial samplings in 45 patients admitted consecutively for myocardial infarction treated by thrombolysis according to the usual indications. Angiographic controls were carried out systematically in the first 24 hours, including 20 cases at the end of thrombolysis. The patients were divided into two groups according to the patency of the infarct related artery: Group I (n = 35) with a patent vessel and Group II (n = 10) with an occluded vessel; 4 patients in Group II were successfully revascularised by angioplasty. The total CK had a higher peak value in Group II (2,393 +/- 1,991 UI/l at 547 +/- 247 min versus 2,888 +/- 2,189 IU/l at 584 +/- 395 min) but the difference was not statistically significant. The analysis of CK isoforms showed the MM3/MM1 ratio to be higher at the 2nd hour in Group I (3.74 +/- 2.37 versus 3.09 +/- 1.43) with a faster increase, without attaining statistical significance. A fourth CK MM fraction was observed at the 2nd hour in 71% of patients in Group I compared with only 20% of patients in Group II. Analysis of myoglobin showed a significantly earlier peak value in Group I (1,218 +/- 1,117 micrograms/l at 133 +/- 62 min versus 1,309 +/- 1,549 micrograms/l at 210 +/- 84 min). The sensitivity and specificity of these different markers were respectively 40%, 86%, 77%, and 60%, 70% and 67% for the CK (peak before 8 hours), the MM3/MM1 ratio (increase of over 35% in the first hour) and myoglobin (peak before 2 hours).(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Creatina Quinase/análise , Infarto do Miocárdio/enzimologia , Mioglobina/análise , Angiocardiografia , Feminino , Humanos , Masculino , Infarto do Miocárdio/metabolismo , Infarto do Miocárdio/terapia , Revascularização Miocárdica , Terapia TrombolíticaRESUMO
To determine if impairment of left ventricular filling is influenced by acute myocardial infarction in patients with arterial hypertension, left ventricular diastolic function was assessed by pulsed doppler echocardiography in 46 patients (pts) subdivided into four groups (Gr): G.1 (n = 12 pts) with acute myocardial infarction and hypertensive heart disease. G.2 (n = 12 pts) acute myocardial infarction without arterial hypertension. G.3 (n = 10 pts) arterial hypertension without history of coronary artery disease. G.4 (n = 12 pts) healthy subjects. Coronary angiography and left ventricular cineangiogram was performed in 24 pts (G.1 + G.2). Peak mitral flow velocity (cm/s) in early diastole (E), atrial systole (A), A/E and int A/int E ratios were measured by pulsed doppler. Age and heart rate were statistically similar in all groups. No difference was found among G.1 and G.2 in ejection fraction, and left ventricular segmental kinetic. (tables; see text) Conclusion left ventricular filling is impaired in pts with arterial hypertension and in pts with acute myocardial infarction; acute myocardial infarction increase the impairment of left ventricular diastolic function in pts with hypertensive heart disease.
Assuntos
Ecocardiografia Doppler , Hipertensão/fisiopatologia , Infarto do Miocárdio/fisiopatologia , Idoso , Diástole , Ventrículos do Coração/fisiopatologia , Humanos , Hipertensão/complicações , Pessoa de Meia-Idade , Infarto do Miocárdio/complicaçõesRESUMO
The authors report a case of myocardial infarction in a 27 year old patient by simultaneous thrombosis of the left anterior descending and right coronary arteries in an angiographically normal coronary circulation. The young age of the patient, the absence of the usual risk factors and a normal angiographic network after arterial recanalisation by angioplasty led to the search for a risk factor of thrombosis. This showed a qualitative deficiency of protein S and the absence of any other abnormality of coagulation or fibrinolysis. This case raises the question of a causal relationship between a hereditary protein S deficiency and thrombotic arterial occlusion.
Assuntos
Trombose Coronária/etiologia , Infarto do Miocárdio/etiologia , Deficiência de Proteína S , Adulto , Angioplastia Coronária com Balão , Testes de Coagulação Sanguínea , Angiografia Coronária , Trombose Coronária/terapia , Humanos , Masculino , Infarto do Miocárdio/terapiaRESUMO
Many enzyme systems such as glutathione peroxidase (GPx) or superoxide dismutase (SOD) neutralise the oxygen derived free radicals produced during myocardial reperfusion by thrombolysis. Erythrocytic SOD, plasma and erythrocytic GPx and their cofactor selenium, substances reacting with thiobarbituric acid (TBARS) were analysed by repeated sampling between T0 and 48 hours in 24 patients treated by thrombolysis for acute myocardial infarction. Angiographic control was undertaken systematically between 60 and 180 minutes after initiating thrombolytic therapy: 18 patients had a patent vessel and 6 patients had an occluded vessel recanalised in 5 cases by angioplasty. Biological analysis was performed in the 23 patients successfully revascularised by thrombolysis, eventually completed by angioplasty. The plasma GPx decreased non-significantly between T0 and 2 hours from 246.8 +/- 53.3 to 233 +/- 39 U/ml with a significant increase between 2 and 48 hours from 233 +/- 39.2 to 294 +/- 76 U/ml, whereas the erythrocytic GPx rose significantly and constantly between T0 and 48 hours from 34.8 +/- 7.1 to 37.6 +/- 7.5 U/gHb with significant consumption of selenium between T0 and 4 hours from 81.2 +/- 14 to 68.5 +/- 12.6 micrograms/l. The erythrocytic SOD increased significantly between T0 and 48 hours from 318.9 +/- 40.8 to 337 +/- 59 U/gHb. Finally, the analysis of plasma TBARS showed a non-significant rise between T0 and 30 minutes from 1.59 +/- 0.30 to 1.71 +/- 1.43 mm/l with a return to the basic line values after about 2 hours. These results show a significant increase in the activity of enzymes protecting against the liberation of oxygen free radicals, such as erythrocyte or plasma GPx and erythrocyte SOD between T0 and 48 hours with consumption of selenium, cofactor of GPx, and an increase in circulating lipid peroxydes in acute myocardial infarction treated by thrombolysis. They also illustrate the oxidative stress which occurs in this situation.