RESUMO
Copper slag is a waste obtained from copper production and it has a limited use, being mainly accumulated in landfills on a massive scale. This material presents a high hardness and it has hydrophobic properties, so it can be used as aggregate replacement in the production of asphalt mixtures. However, each size of copper slag behaves differently when used in asphalt mixes, especially under changing conditions of moisture or temperature. Precisely these climatic factors directly affect the service life of asphalt pavements. In this research, semi-dense graded asphalt mixtures were produced with copper slag as replacement of aggregates, varying the particle sizes used in the range from 2.5 to 0.08 mm to determine the size of copper slag with the best performance. Indirect tensile strength tests were used to analyze samples subjected to different moisture and temperature conditions and ageing degrees. The results show that copper slag can be used as aggregate replacement in asphalt mixes when the proper size is selected. The strength of the asphalt mixture increased as the size of the copper slag increased, especially under variable moisture and ageing conditions. Superior behaviour compared to a reference mixture was obtained when replacing the size of aggregate No. 8 with copper slag, increasing its indirect tensile strength and retained strength, reducing its stiffness under all the ageing periods, and being equally effective at the different temperatures, which results in mixtures with improved durability and delayed cracking. Furthermore, it would help to reduce between 15 and 20% of the virgin aggregate needed to produce asphalt mixes and it would also allow reducing the accumulated volume of this waste, decreasing the environmental impact of both industries.
Assuntos
Materiais de Construção , Resíduos Industriais , Cobre , HidrocarbonetosRESUMO
BACKGROUND: The BSP090 project aims at establishing European Pharmacopoeia Reference Substances in combination with the corresponding ELISA methods for the quantification of major allergens in allergen products. Two sandwich ELISAs proved suitable for quantification of Bet v 1, the major birch pollen allergen, in preceding phases of BSP090. METHODS: Two Bet v 1-specific ELISA systems were compared with respect to accuracy and precision in a ring trial including 13 laboratories. Model samples containing recombinant rBet v 1.0101 as well as native birch pollen extracts were measured independently at least three times in each facility. The assessment was completed with a comparative quantification of Bet v 1 in 30 marketed birch allergen products in one laboratory, simulating the future use as reference method. RESULTS: In the collaborative study, both candidate ELISAs confirmed their suitability to quantify recombinant and native Bet v 1. ELISA-A showed higher precision and lower interlaboratory variability, yet ELISA-B exhibited slightly higher accuracy. Subsequent parallel measurement of Bet v 1 in a panel of 'real-life' birch allergen products indicated better repeatability of ELISA-B. Both systems detected substantial differences in Bet v 1 content between allergen products, but the effect was more pronounced using ELISA-B due to persistently higher values compared to ELISA-A. CONCLUSIONS: In the collaborative study, no deciding differences were observed between the two candidate ELISAs. Further comparison under conditions simulating the intended use combined with the criterion of long-term availability enabled the selection of one Bet v 1-specific ELISA for proposal as European Pharmacopoeia standard method.
Assuntos
Alérgenos , Antígenos de Plantas , Produtos Biológicos/normas , Alérgenos/imunologia , Antígenos de Plantas/imunologia , Betula/imunologia , Ensaio de Imunoadsorção Enzimática , Humanos , Reprodutibilidade dos TestesRESUMO
Calcifying tendinopathy (CT) of the shoulder is a common painful disorder, although the etiology and pathogenesis remain largely unknown. Recent theories about the role of excessive mechanical load in the genesis of CT have been proposed. Driven by the interest for these new theories, we investigated the hypothesis of a relationship between work-related repetitive movements of the upper arm, considered a potential cause of shoulder overload, and the presence of shoulder CT. A secondary aim was to obtain data on CT prevalence in a female sample from the working-age general population, as little data currently exist. 199 supermarket cashiers and 304 female volunteers recruited from the general population underwent a high-resolution ultrasonography of the rotator cuffs of both shoulders, and the presence of tendinopathies, with or without calcification, was recorded. The prevalence of calcific tendinopathy was 22.6 % in the cashiers group and 24.4 % in the control group. There were no statistically significant differences in the prevalence of calcifications between the two groups (p = 0.585), either for the dominant shoulder [OR = 0.841 (95 % CI 0.534-1.326)] or for the non-dominant shoulder [OR = 0.988 (95 % CI 0.582-1.326)]. We observed bilateral calcifications in 8.5 % of cashiers, and 9.6 % of controls, and an increase in prevalence of CT with age in both groups. Work-related repetitive movements of the upper arm did not induce a higher prevalence of shoulder CT compared with the female sample from the general population. If CT etiopathogenesis is related to mechanical load, CT onset may be influenced not only by loading history, but also by individual factors. Level of evidence Prognosis study, Level II.
Assuntos
Calcinose/epidemiologia , Movimento , Exposição Ocupacional/estatística & dados numéricos , Manguito Rotador/diagnóstico por imagem , Tendinopatia/epidemiologia , Adulto , Fatores Etários , Calcinose/diagnóstico por imagem , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Tendinopatia/diagnóstico por imagem , Ultrassonografia , Adulto JovemRESUMO
Pervious pavements have become one of the most used sustainable urban drainage system (SUDS) techniques in car parks. This research paper presents the results of monitoring water quality from several experimental car park areas designed and constructed in Spain with bays made of interlocking concrete block pavement, porous asphalt, polymer-modified porous concrete and reinforced grass with plastic and concrete cells. Moreover, two different sub-base materials were used (limestone aggregates and basic oxygen furnace slag). This study therefore encompasses the majority of the materials used as permeable surfaces and sub-base layers all over the world. Effluent from the test bays was monitored for dissolved oxygen, pH, electric conductivity, total suspended solids, turbidity and total petroleum hydrocarbons in order to analyze the behaviour shown by each combination of surface and sub-base materials. In addition, permeability tests were undertaken in all car parks using the 'Laboratorio Caminos Santander' permeameter and the Cantabrian Portable Infiltrometer. All results are presented together with the influence of surface and sub-base materials on water quality indicators using bivariate correlation statistical analysis at a confidence level of 95%. The polymer-modified porous concrete surface course in combination with limestone aggregate sub-base presented the best performance.
Assuntos
Estacionamentos , Qualidade da Água , Materiais de Construção/normas , Drenagem Sanitária/normas , Estacionamentos/normas , Qualidade da Água/normasRESUMO
In contrast to conventional non-biobased adsorbents, lignin emerges as a cost-effective and environmentally benign alternative for water treatment. This study identifies unexpected and unpredicted multifunctional properties of lignin nanoparticles (LNPs). LNPs, which are prepared by simple physical processes, demonstrated for the first time to behave as multifunctional materials able to adsorb and photodegrade methylene blue (MB) in aqueous medium upon UV irradiation. Furthermore, the synthetic approach adopted to synthesize LNPs - and therefore their surface properties - strongly affects their performances. More specifically, LNPs obtained by solvent-antisolvent nanoprecipitation (SLNPs) show the highest MB adsorption properties (98 % removal), reaching a maximum adsorption capacity of 43.0â mg g-1, and the fastest adsorption kinetics with respect to other lignin-based adsorbents. Conversely, hydrotropic LNPs (HLNPs) exhibit exceptional photocatalytic activity, resulting in 98 % MB degradation over 6â hours of UV irradiation, combined with the ability to be easily recycled and reused. The present effort paves the way for the use of LNPs as efficient multifunctional materials able to perform concurrently adsorption and photocatalytic degradation of dye pollutants, toward the creation of a sustainable biobased water treatment platform.
RESUMO
This is a retrospective, non-comparative study of 212 consecutive patients who underwent Total Hip Arthroplasty with an uncemented hydroxyapatite (HA) coated stem system from November 1997 to March 2000. The objective of the study was to analyze the performance of the implant at a minimum of 10 years in older patients (mean age 79.6 years). The Kaplan-Meier survivorship of the femoral stem at 10 years was 100%, and 97.5% for the whole prosthesis. The mean Merle d'Aubigné clinical score improved from 4.4 ± 2.1 points pre-operatively to 13.39 ± 3.77 points at final follow-up (p<0.05), and the mean VAS score for thigh pain was 1.25. The radiographic analysis showed that there were no significant radiolucent lines or osteolysis compromising the fixation of the implant.
Assuntos
Artroplastia de Quadril , Durapatita , Fêmur/cirurgia , Prótese de Quadril , Osteoartrite do Quadril/cirurgia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/cirurgia , Humanos , Incidência , Estimativa de Kaplan-Meier , Estudos Longitudinais , Masculino , Dor/epidemiologia , Desenho de Prótese , Radiografia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
INTRODUCTION: Colonic atresia is a rare malformation accounting for 1.8-15% of all intestinal atresias. We present a 6-case series along with a bibliographic review. CLINICAL CASE: This 6-case series consists of three female cases and three male cases diagnosed 24-84 hours following birth. They were all located in the right hemicolon. The most relevant clinical signs included abdominal distension, absence of defecation, and bilious to fecal vomit. Repairs included primary or step-by-step anastomoses for bowel transit reconstruction. One patient diagnosed at > 72 hours of life died. CONCLUSION: In our experience with colonic atresia, when primary or step-by-step intestinal recanalization (diversion for future repair) is achieved, the expected prognosis is excellent, provided that colonic atresia has been diagnosed at 24-48 hours of life.
INTRODUCCION: Las atresias de colon son malformaciones raras que comprenden alrededor de 1,8-15% de total de las atresias intestinales. Presentamos una serie de seis casos junto con una revisión bibliográfica. CASO CLINICO: Esta serie de casos incluye tres casos femeninos y tres casos masculinos que fueron diagnosticados entre 24-84 horas del nacimiento. Todas se localizaron en el hemicolon derecho. Las manifestaciones clínicas más relevantes fueron distensión abdominal, ausencia de evacuaciones, vómitos de biliosos a fecaloideos. Las correcciones incluyen anastomosis primarias o por etapas para la reconstrucción del tránsito intestinal. Se presentó una defunción en un paciente diagnosticado con >â¯72 horas de vida. CONCLUSION: En nuestra experiencia, en la atresia de colon, cuando se logra recanalizar el intestino de forma primaria o por etapas (derivación para la futura corrección), se espera excelente pronóstico, siempre que sea diagnosticada entre las 24 a 48 horas de vida.
Assuntos
Atresia Intestinal , Colo/anormalidades , Feminino , Humanos , Recém-Nascido , Atresia Intestinal/cirurgia , MasculinoRESUMO
Hydrogen production via light-driven water splitting is a key process in the context of solar energy conversion. In this respect, the choice of suitable light-harvesting units appears as a major challenge, particularly as far as stability issues are concerned. In this work, we report on the use of CdTe/CdS QDs as photosensitizers for light-assisted hydrogen evolution in combination with a nickel bis(diphosphine) catalyst (1) and ascorbate as the sacrificial electron donor. QDs of different sizes (1.7-3.4 nm) and with different capping agents (MPA, MAA, and MSA) have been prepared and their performance assessed in the above-mentioned photocatalytic reaction. Detailed photophysical studies have been also accomplished to highlight the charge transfer processes relevant to the photocatalytic reaction. Hydrogen evolution is observed with remarkable efficiencies when compared to common coordination compounds like Ru(bpy)32+ (where bpy = 2,2'-bipyridine) as light-harvesting units. Furthermore, the hydrogen evolution performance under irradiation is strongly determined by the nature of the capping agent and the QD size and can be related to the concentration of the surface defects within the semiconducting nanocrystal. Overall, the present results outline how QDs featuring large quantum yields and long lifetimes are desirable to achieve sustained hydrogen evolution upon irradiation and that a precise control of the structural and photophysical properties thus appears as a major requirement towards profitable photocatalytic applications.
RESUMO
The metabolic syndrome (MS) is associated with structural and functional alterations of the left ventricle (LV); no evidence is available on the impact of the MS on the right ventricle (RV). To assess whether MS, as defined by the ATP III report, is associated with biventricular hypertrophy, a total of 286 hypertensive subjects (mean age 58.7+/-12.2 years) attending our outpatient clinic underwent the following procedures: (1) physical examination and standard clinic blood pressure (BP) measurement; (2) routine laboratory investigations; (3) M-mode, two-dimensional and Doppler echocardiography. LV hypertrophy (LVH) was defined by LM mass index>or=51/47 g m(-2.7) in men and women, respectively. Right-sided chambers were measured in parasternal long axis at the outflow tract and subcostal view; RV hypertrophy (RVH) was defined by anterior RV wall thickness>or=6.0/5.5 mm in men and women, respectively. Filling velocities of both ventricles were assessed by pulsed Doppler echocardiography. Structural cardiac alterations were more pronounced in hypertensive men and women with MS than in their non-MS counterparts and involved both ventricles as shown by the differences in continuous variables as well as in prevalence rates of LVH (58 and 48% vs 28 and 30%, respectively, P<0.01) and RVH (48 and 54% vs 25 and 35%, respectively, P<0.01). Both LV and RV filling in MS hypertensives were more dependent on the atrial systole. Our study shows that in human hypertension, structural and functional cardiac changes induced by MS are not limited to the LV but also involve the right one.
Assuntos
Hipertensão/complicações , Hipertrofia Ventricular Esquerda/etiologia , Hipertrofia Ventricular Direita/etiologia , Síndrome Metabólica/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Pressão Sanguínea , Ecocardiografia Doppler de Pulso , Feminino , Humanos , Hipertensão/sangue , Hipertensão/diagnóstico por imagem , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/sangue , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/fisiopatologia , Hipertrofia Ventricular Direita/sangue , Hipertrofia Ventricular Direita/diagnóstico por imagem , Hipertrofia Ventricular Direita/fisiopatologia , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico por imagem , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Adulto JovemRESUMO
Courtships sounds and associated behaviours were recorded in the Canestrini's goby Pomatoschistus canestrinii using a simultaneous video-acoustic system: the male exhibited a display composed of both a visual (rapid head movements) and an acoustic component (thump sound), and its intensity was positively associated with that of a female visual display.
Assuntos
Comunicação Animal , Perciformes/fisiologia , Comportamento Sexual Animal/fisiologia , Animais , Feminino , MasculinoRESUMO
This study, carried out in a large cohort of treated essential hypertensives attending an out-patient hospital hypertension clinic, extends previous observations by showing that a clustering of two or three markers of organ damage (OD) has a higher prevalence than a single organ involvement. These findings call for a systematic evaluation of cardiac and extracardiac OD in treated hypertensive patients referred to a specialist setting.
Assuntos
Hipertensão/complicações , Insuficiência de Múltiplos Órgãos/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/etiologia , Prevalência , Fatores de Risco , Adulto JovemRESUMO
Limited evidence is available about the relationship between ambulatory heart rate (HR) and target organ damage (TOD) in uncomplicated hypertension. We sought to investigate the association between ambulatory HR and subclinical cardiac, vascular and renal markers of TOD in never-treated essential hypertensives. A total of 580 subjects with recently diagnosed (Assuntos
Albuminúria/complicações
, Doenças das Artérias Carótidas/patologia
, Frequência Cardíaca/fisiologia
, Hipertensão/patologia
, Hipertensão/fisiopatologia
, Hipertrofia Ventricular Esquerda/patologia
, Adulto
, Arteriosclerose/patologia
, Monitorização Ambulatorial da Pressão Arterial
, Artérias Carótidas
, Feminino
, Humanos
, Masculino
, Síndrome Metabólica/complicações
RESUMO
Knowledge about pollutant wash-off from urban impervious surfaces is a key feature for developing effective management strategies. Accordingly, further information is required about urban areas under semi-arid climate conditions at the sub-catchment scale. This is important for designing source control systems for pollution. In this study, a characterization of pollutant wash-off has been performed over sixteen months, at the sub-catchment scale for urban roads as impervious surfaces. The study was conducted in Valencia, Spain, a city with a Mediterranean climate. The results show high event mean concentrations for suspended solids (98mg/l), organic matter (142mgCOD/l, 25mgBOD5/l), nutrients (3.7mgTN/l, 0.4mgTP/l), and metals (0.23, 0.32, 0.62 and 0.17mg/l for Cu, Ni, Pb, and Zn, respectively). The results of the runoff characterization highlight the need to control this pollution at its source, separately from wastewater because of their different characteristics. The wash-off, defined in terms of mobilized mass (g/m2) fits well with both process-based and statistical models, with the runoff volume and rainfall depth being the main explanatory variables. Based on these results and using information collected from hydrographs and pollutographs, an approach for sizing sustainable urban drainage systems (SuDS), focusing on water quality and quantity variables, has been proposed. By setting a concentration-based target (TSS discharged to receiving waters <35mg/l), the results indicate that for a SuDS type detention basin (DB), an off-line configuration performs better than an on-line configuration. The resulting design criterion, expressed as SuDS volume per unit catchment area, assuming a DB type SuDS, varies between 7 and 10l/m2.
RESUMO
The relationship between ambulatory blood pressure (ABP), target organ damage (TOD) and aortic root (AR) size in human hypertension has not been fully explored to date. We investigated the relationship between ABP, different markers of TOD and AR size in never-treated essential hypertensive patients. A total of 519 grade 1 and 2 hypertensive patients (mean age 46+/-12 years) referred for the first time to our outpatient clinic underwent the following procedures: (1) routine examination, (2) 24 h urine collection for microalbuminuria (MA), (3) ambulatory blood pressure monitoring over two 24 h periods within 4 weeks, (4) echocardiography and (5) carotid ultrasonography. AR dilatation was defined by sex-specific criteria (> or =40 mm in men and > or =37 mm in women). AR diameter was increased in 3.7% of patients. Demographic variables (body mass index, age and male gender), average night-time diastolic blood pressure (BP) (but not clinic or average 48 h BP), left ventricular mass index and carotid intima-media (IM) thickness showed an independent association with AR size in both univariate and multivariate analyses. When TOD data were analysed in a categorical way, a stepwise increase in the prevalence of left ventricular hypertrophy (LVH) (I=17.5%, II=27.6%, III=35.8%) and carotid IM thickening (I=20.9%, II=28.8%, III=34.4%), but not in MA (I=6.8%, II=9.1%, III=8.7%) was found with the progression of AR size tertiles. Our results show that (1) AR enlargement in uncomplicated never-treated hypertensive patients has a markedly lower prevalence than traditional markers of cardiac and extracardiac TOD; (2) night-time BP, LVH and carotid IM thickening are independent predictors of AR dimension.
Assuntos
Aorta/patologia , Hipertensão/patologia , Adulto , Monitorização Ambulatorial da Pressão Arterial , Artérias Carótidas/patologia , Dilatação Patológica/epidemiologia , Feminino , Humanos , Hipertrofia Ventricular Esquerda/patologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
The aim of this study was to compare the accuracy of linear measurements of the distance between the mandibular cortical bone and the mandibular canal using 64-detector multi-slice computed tomography (MSCT) and cone beam computed tomography (CBCT). It was sought to evaluate the reliability of these examinations in detecting the mandibular canal for use in bilateral sagittal split osteotomy (BSSO) planning. Eight dry human mandibles were studied. Three sites, corresponding to the lingula, the angle, and the body of the mandible, were selected. After the CT scans had been obtained, the mandibles were sectioned and the bone segments measured to obtain the actual measurements. On analysis, no statistically significant difference was found between the measurements obtained through MSCT and CBCT, or when comparing the measurements from these scans with the actual measurements. It is concluded that the images obtained by CT scan, both 64-detector multi-slice and cone beam, can be used to obtain accurate linear measurements to locate the mandibular canal for preoperative planning of BSSO. The ability to correctly locate the mandibular canal during BSSO will reduce the occurrence of neurosensory disturbances in the postoperative period.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Osteotomia Sagital do Ramo Mandibular , Tomografia Computadorizada por Raios X , Pontos de Referência Anatômicos , Humanos , Técnicas In Vitro , Reprodutibilidade dos TestesRESUMO
To date, the potency of allergen products in Europe is expressed in manufacturer-specific units relative to a product-specific in-house reference. Consequently, cross-product comparability of allergen products from different manufacturers with respect to strength and efficacy is impossible. The Biological Standardisation Programme (BSP) project BSP090 addresses this issue via the establishment of reference standards in conjunction with ELISA methods for the quantification of major allergens in allergen products. Since the initiation of BSP090, the recombinant major allergen Bet v 1 has been adopted by the European Pharmacopoeia Commission as a Chemical Reference Substance (CRS). In parallel, two sandwich ELISA systems for quantification of Bet v 1 were found suitable in preliminary phases of BSP090 to be validated in a large collaborative study. In this study, the candidate ELISA systems were compared with respect to accuracy, precision and variability. Thirteen participating laboratories tested model samples containing the CRS as well as spiked and unspiked birch pollen extracts. Both in pre-testing and in the collaborative study, the 2 candidate ELISA systems confirmed their suitability to quantify recombinant and native Bet v 1. As no clear-cut decision for one of the ELISA systems could be made based on the results of the collaborative study, a post-study testing was performed. Bet v 1 content of 30 birch pollen allergen products was determined in parallel in both ELISA systems. Consequently, 1 candidate ELISA system was selected to be proposed as the future European Pharmacopoeia standard method for Bet v 1 quantification.
Assuntos
Alérgenos/análise , Antígenos de Plantas/análise , Produtos Biológicos/análise , Ensaio de Imunoadsorção Enzimática , Proteínas de Plantas/análise , Alérgenos/imunologia , Antígenos de Plantas/imunologia , Produtos Biológicos/imunologia , Produtos Biológicos/normas , Ensaio de Imunoadsorção Enzimática/normas , Europa (Continente) , Humanos , Proteínas de Plantas/imunologia , Proteínas de Plantas/normas , Controle de Qualidade , Padrões de Referência , Reprodutibilidade dos TestesRESUMO
Isolated ambulatory hypertension is a condition characterized by elevated ambulatory but normal clinic blood pressure (BP), and has been reported to be associated with increased cardiovascular risk in untreated subjects. However, little is known about the relationship between this condition and intermediate end points such as target organ damage (TOD) in treated hypertensives. We investigated the impact of isolated ambulatory hypertension on left ventricular hypertrophy (LVH) and microalbuminuria (MA) in a selected sample of treated nondiabetic hypertensives with effective and prolonged clinic BP control (BP<140/90 mmHg). Clinic BP measurements, routine diagnostic procedures, echocardiography and 24-h urine collection for MA, were undertaken in 80 patients (mean age 53+/-8 years) with essential hypertension attending our hospital outpatient centre at baseline and after an average follow-up of 30 months. At follow-up evaluation BP status was assessed by self-measurement of BP and ambulatory BP monitoring (ABPM). At the follow-up visit, 51 out of 80 patients (63.7%) reached a BP control according to ABP (average daytime BP<132/85 mmHg) criteria (group I) whereas the remaining 29 did not (group II); home BP was controlled (BP<135/85 mmHg) in all members of group I and in 86% of group II. In the overall study population, mean Sokolow voltage, LV mass index (LVMI) and urinary albumin excretion (UAE) decreased compared to baseline from 24.1+/-5.0 to 18.9+/-5.1 mm (P<0.05), 115.6+/-24.1 to 97.7+/-21.6 g/m(2) (P<0.01), 11.8+/-23.7 to 5.8+/-14.9 mg/24 h (P<0.05), respectively. The prevalence of ECG LVH, altered LV patterns and MA fell from 7.5 to 2.5% (P=NS), from 45 to 25 (P<0.01) and from 13.7 to 5.1% (P<0.05), respectively. However, when data were analysed separately for the two groups a significant decrease of echo LVH and MA was found only in patients with controlled ABP. LVMI and MA decreased from 117.1+/-23.1 to 95.9+/-22.1 g/m(2) (P<0.01) and 12.8+/-24.7 to 4.1+/-5.7 mg/24 h (P<0.05) in group I, and from 114.1+/-24.8 to 102.3+/-20.3 (P=NS) and 11.9+/-22.1 to 6.3+/-18.1 mg/24 h (P=NS) in group II. In conclusion, in the present study isolated ambulatory hypertension in treated patients is associated with a lack of regression in cardiac and extracardiac TOD, suggesting that a tight BP control throughout the 24 h plays a key role in lowering hypertension-induced structural and functional alterations at cardiac and renal level.
Assuntos
Albuminúria/fisiopatologia , Anti-Hipertensivos/uso terapêutico , Monitorização Ambulatorial da Pressão Arterial , Hipertensão/tratamento farmacológico , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Albuminúria/etiologia , Ecocardiografia , Eletrocardiografia , Feminino , Seguimentos , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertrofia Ventricular Esquerda/etiologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Pessoa de Meia-IdadeAssuntos
Dor Abdominal/diagnóstico por imagem , Trombose/diagnóstico por imagem , Dor Abdominal/etiologia , Progressão da Doença , Fibrinolíticos/administração & dosagem , Heparina/administração & dosagem , Hepatomegalia/diagnóstico por imagem , Hepatomegalia/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Veia Porta/diagnóstico por imagem , Trombose/tratamento farmacológico , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
BACKGROUND: Pulmonary artery dilatation is a common feature among patients with severe pulmonary hypertension. Left main coronary artery extrinsic compression by an enlarged pulmonary artery is a rare complication and a potential cause for chest pain and sudden cardiac death in patients with pulmonary hypertension. This situation is very rare and few reports have described it. Currently, the appropriate management of these patients remains unknown. CASE REPORT: In the present report we describe the case of a 39-year-old woman who presented with a 2-year history of cardiac symptoms related to exercise. The patient underwent a 64-slice multidetector computed tomography (MDCT) coronary angiography, which showed left main coronary artery (LMCA) compression by a markedly enlarged pulmonary artery trunk (44 mm), without intraluminal stenosis or coronary artery calcium, as determined by the Agatston score. This compression was considered to be the cause of the cardiac symptoms. To confirm and plan the treatment, the patient underwent cardiac catheterization that confirmed the diagnosis of pulmonary hypertension and LMCA critical obstruction. Taking into account the paucity of information regarding the best management in these cases, the treatment decision was shared among a "heart team" that chose percutaneous coronary intervention with stent placement. An intra-vascular ultrasound was performed during the procedure, which showed a dynamic compression of the left main coronary artery. The intervention was successfully executed without any adverse events. CONCLUSIONS: This case illustrates dynamic compression of the LMCA by IVUS, visually demonstrating the mechanism of the intermittent symptoms of myocardial ischemia in this kind of patient. It also shows that percutaneous stenting technique may be an appropriate treatment for this unusual situation.
Assuntos
Oclusão Coronária/diagnóstico por imagem , Hipertensão Pulmonar/complicações , Artéria Pulmonar/diagnóstico por imagem , Ultrassonografia de Intervenção/métodos , Adulto , Angiografia Coronária , Oclusão Coronária/etiologia , Feminino , Seguimentos , Humanos , Hipertensão Pulmonar/diagnóstico por imagem , Hipertensão Pulmonar/fisiopatologia , Tomografia Computadorizada MultidetectoresRESUMO
Dihydroergocryptine (DHECP), an ergot alkaloid with potent dopaminergic activity, was injected acutely or subchronically to aged (24 months old) male rats of the F344 strain, at the dose of 0.05 or 0.1 mg/kg. The immobility in the "despair" test (constrained swim) was longer in 24-month-old rats than in younger animals. This behavioral change was reduced in rats treated subchronically with DHECP, but no significant change was found in animals with acute treatment. Aged rats showed an increased haloperidol-induced catalepsy and a reduced motor performance and coordination as compared to animals of 2 and 10 months of age. Acute treatment with DHECP was followed by an attenuation of haloperidol-induced catalepsy and an improvement of motor performance and coordination of aged rats. Similar results were obtained after subchronic treatment with DHECP, but the effect on the rotorod behavior was more potent after subchronic treatment than after acute injection of the drug. It is possible that the improvement of behavioral deficits of aged rats after the treatment with DHECP depends on the facilitating effect of this drug on central dopamine transmission that may be impaired in these animals.