RESUMEN
Abstract Petroleum water soluble fraction (WSF) impairs organisms, but damages may vary among cell and tissue levels. The aim of the present study was to evaluate the acute (24 h, 48 h, 72 h) and subchronic effects (36 days) of WSF (0%, 25% and 100%) in juveniles of the Neotropical top predator fish Hoplias aff. malabaricus. The effects of WSF were evaluated at a molecular level using the comet assay and micronucleus test for genome damage; and at a morphological level through histological identification of liver pathologic lesions. In both acute and subchronic exposure we found low levels of DNA damage ( 10% of comet tail) and non-significant frequency of micronucleus in WSF exposed fish. The most significant liver lesions in WSF exposed fish were fatty vacuolization, hypertrophy and focal necrosis. Since these tissue injuries were progressive and persistent, their irreversibility may negatively affect fish recruitment, even in a such resistant top predator.
Resumo A fração solúvel de petróleo (WSF) prejudica os organismos, porém os danos podem variar entre os níveis celular e tecidual. O objetivo do presente estudo foi avaliar o efeito agudo (24 h, 48 h e 72 h) e subcrônico (36 dias) da WSF (0%, 25% e 100%) em juvenis do peixe neotropical predador topo Hoplias aff. malabaricus. Os efeitos da WSF foram avaliados no nível molecular utilizando o ensaio do cometa e o teste do micronúcleo para o dano genômico e no nível morfológico através da identificação histológica de lesões patológicas no fígado. Em ambas exposições (aguda e subcrônica) encontramos baixos níveis de dano no DNA ( 10% de DNA na cauda do cometa) e frequência de micronúcleos não significativa em peixes expostos a WSF. As lesões mais significativas no fígado dos peixes expostos a WSF foram a vacuolização lipídica, hipertrofia e focos de necroses. Como estas lesões foram progressivas e persistentes, sua irreversibilidade pode afetar negativamente o recrutamento dos peixes, mesmo sendo um predador topo resistente.
RESUMEN
Abstract Petroleum water soluble fraction (WSF) impairs organisms, but damages may vary among cell and tissue levels. The aim of the present study was to evaluate the acute (24 h, 48 h, 72 h) and subchronic effects (36 days) of WSF (0%, 25% and 100%) in juveniles of the Neotropical top predator fish Hoplias aff. malabaricus. The effects of WSF were evaluated at a molecular level using the comet assay and micronucleus test for genome damage; and at a morphological level through histological identification of liver pathologic lesions. In both acute and subchronic exposure we found low levels of DNA damage (< 10% of comet tail) and non-significant frequency of micronucleus in WSF exposed fish. The most significant liver lesions in WSF exposed fish were fatty vacuolization, hypertrophy and focal necrosis. Since these tissue injuries were progressive and persistent, their irreversibility may negatively affect fish recruitment, even in a such resistant top predator.
Resumo A fração solúvel de petróleo (WSF) prejudica os organismos, porém os danos podem variar entre os níveis celular e tecidual. O objetivo do presente estudo foi avaliar o efeito agudo (24 h, 48 h e 72 h) e subcrônico (36 dias) da WSF (0%, 25% e 100%) em juvenis do peixe neotropical predador topo Hoplias aff. malabaricus. Os efeitos da WSF foram avaliados no nível molecular utilizando o ensaio do cometa e o teste do micronúcleo para o dano genômico e no nível morfológico através da identificação histológica de lesões patológicas no fígado. Em ambas exposições (aguda e subcrônica) encontramos baixos níveis de dano no DNA (< 10% de DNA na cauda do cometa) e frequência de micronúcleos não significativa em peixes expostos a WSF. As lesões mais significativas no fígado dos peixes expostos a WSF foram a vacuolização lipídica, hipertrofia e focos de necroses. Como estas lesões foram progressivas e persistentes, sua irreversibilidade pode afetar negativamente o recrutamento dos peixes, mesmo sendo um predador topo resistente.
Asunto(s)
Animales , Contaminantes Químicos del Agua/toxicidad , Petróleo/toxicidad , Characiformes , Agua Dulce , HígadoRESUMEN
Petroleum water soluble fraction (WSF) impairs organisms, but damages may vary among cell and tissue levels. The aim of the present study was to evaluate the acute (24 h, 48 h, 72 h) and subchronic effects (36 days) of WSF (0%, 25% and 100%) in juveniles of the Neotropical top predator fish Hoplias aff. malabaricus. The effects of WSF were evaluated at a molecular level using the comet assay and micronucleus test for genome damage; and at a morphological level through histological identification of liver pathologic lesions. In both acute and subchronic exposure we found low levels of DNA damage (< 10% of comet tail) and non-significant frequency of micronucleus in WSF exposed fish. The most significant liver lesions in WSF exposed fish were fatty vacuolization, hypertrophy and focal necrosis. Since these tissue injuries were progressive and persistent, their irreversibility may negatively affect fish recruitment, even in a such resistant top predator.
Asunto(s)
Characiformes , Petróleo , Contaminantes Químicos del Agua , Animales , Agua Dulce , Hígado , Petróleo/toxicidad , Contaminantes Químicos del Agua/toxicidadRESUMEN
Core body temperature (CBT) is one of the main vital signs that is used to evaluate the health status of pigs. The most common and feasible method for assessing CBT in pigs is rectal temperature (RT). Obtaining RT is stressful for animals, may generate inaccurate results, and has the risk of spreading disease. Infrared imaging (IR) thermography of the body of pigs may be a safer and less stressful alternative to RT. The objective of the current study was to evaluate the efficacy of using IR as an alternative for monitoring CBT in pigs. Twenty-three gilts (30.5 ± 5.62 kg BW) were housed in metabolism crates in an environmentally controlled facility and fed an 860 g/d grower diet. After 4 d of adaptation, the febrile response was induced by intramuscular injection of lipopolysaccharide (LPS; 25 µg/kg BW). Each pig's body temperature was recorded at 0, 2, 4, 6, 8, 10, and 24 h after LPS challenge using the following 3 methods: 1) RT, 2) IR of the eye and ear, and 3) CBT using an orally administered digital temperature sensor. Statistical analysis was performed in a completely randomized design in SAS using Mixed, Correlation, and Regression procedures. Relative to time 0 h, LPS increased the eye temperature, CBT, and RT by 0.92, 1.32, and 1.48°C, respectively ( < 0.01), but had no significant effect on ear temperature. Eye temperature, RT, and CBT, but not ear temperature, were highly correlated ( ≥ 0.96) during the course of the study ( < 0.01). Estimated regression parameters (α and ß) for predicting CBT using eye temperature were -28.2 ± 8.70 and 1.76 ± 0.221, respectively, and for RT were -24.5 ± 7.69 and 1.65 ± 0.196, respectively ( ≥ 0.96; 95% confidence interval). Collectively, these results indicated a strong relationship between eye temperature, RT, and CBT in pigs. Therefore, IR of the eye can be used as a precise, noncontact alternative to RT measurements for monitoring CBT in swine.
Asunto(s)
Temperatura Corporal/fisiología , Fiebre/veterinaria , Lipopolisacáridos/toxicidad , Enfermedades de los Porcinos/inducido químicamente , Animales , Femenino , Fiebre/inducido químicamente , Fiebre/diagnóstico , Rayos Infrarrojos , Porcinos , Enfermedades de los Porcinos/diagnóstico , Termografía/métodosRESUMEN
The first record of pughead deformity in a Neotropical freshwater fish not raised in captivity is provided, based on an adult male of Cichla kelberi introduced into an estuary of Rio de Janeiro State, south-eastern Brazil. A general biological characterization of the specimen is provided and aspects of its aberrant anatomy are described. Environmental and biological factors that may cause pughead deformity in fishes are discussed.
Asunto(s)
Cíclidos/anomalías , Animales , Brasil , Cíclidos/anatomía & histología , Estuarios , Agua Dulce , Especies Introducidas , Masculino , Cráneo/anomalías , Cráneo/anatomía & histologíaRESUMEN
The relationships between fish composition, connectivity and morphometry of 103 lagoons in nine freshwater ecoregions (FEOW) between 2·83° S and 37·64° S were evaluated in order to detect possible congruence between the gradient of species richness and similarities of assemblage composition. Most lagoons included in the study were <2 km(2) , with a maximum of 3975 km(2) in surface area. Combined surface area of all lagoons included in the study was 5411 km(2) . Number of species varied locally from one to 76. A multiple regression revealed that latitude, attributes of morphometry and connectivity, and sampling effort explained a large amount of variability in species richness. Lagoon area was a good predictor of species richness except in low latitude ecoregions, where lagoons are typically small-sized and not affected by marine immigrants, and where non-native fish species accounted for a significant portion of species richness. Relationships between species and area in small-sized lagoons (<2 km(2) ) is highly similar to the expected number in each ecoregion, with systems located between 18·27° S and 30·15° S attaining higher levels of species richness. Similarities in species composition within the primary, secondary and peripheral or marine divisions revealed strong continental biogeographic patterns only for species less tolerant or intolerant to salinity. Further support for the FEOW scheme in the eastern border of South America is therefore provided, and now includes ecotonal systems inhabited simultaneously by freshwater and marine species of fishes.
Asunto(s)
Biodiversidad , Peces , Animales , Océano Atlántico , Agua Dulce , América del SurRESUMEN
The influence of the water-soluble fraction of petroleum (WSF) on prey consumption and growth of juvenile trahira Hoplias aff. malabaricus was investigated. Juveniles were submitted to either WSF or Control treatment over 28 days, and jewel tetra Hyphessobrycon eques adults were offered daily as prey for each predator. Total prey consumption ranged from 16 to 86 individuals. Despite the initially lower prey consumption under WSF exposure, there were no significant differences in overall feeding rates between the two treatments. Water-soluble fraction of petroleum had a negative effect on the growth in length of H. aff. malabaricus juveniles. Although unaffected, prey consumption suggested a relative resistance in H. aff. malabaricus to WSF exposition and the lower growth of individuals exposed to WSF than the Control possibly reflects metabolic costs. The implications of the main findings for the individual and the food chain are discussed, including behavioral aspects and the role played by this predator in shallow aquatic systems.
Asunto(s)
Characiformes/fisiología , Conducta Alimentaria/efectos de los fármacos , Petróleo/efectos adversos , Contaminantes Químicos del Agua/efectos adversos , Animales , Characiformes/crecimiento & desarrolloRESUMEN
Abstract The influence of the water-soluble fraction of petroleum (WSF) on prey consumption and growth of juvenile trahira Hoplias aff. malabaricus was investigated. Juveniles were submitted to either WSF or Control treatment over 28 days, and jewel tetra Hyphessobrycon eques adults were offered daily as prey for each predator. Total prey consumption ranged from 16 to 86 individuals. Despite the initially lower prey consumption under WSF exposure, there were no significant differences in overall feeding rates between the two treatments. Water-soluble fraction of petroleum had a negative effect on the growth in length of H. aff. malabaricus juveniles. Although unaffected, prey consumption suggested a relative resistance in H. aff. malabaricus to WSF exposition and the lower growth of individuals exposed to WSF than the Control possibly reflects metabolic costs. The implications of the main findings for the individual and the food chain are discussed, including behavioral aspects and the role played by this predator in shallow aquatic systems.
Resumo A influência da fração solúvel de petróleo (FSP) no consumo de presas e crescimento de juvenis da traíra Hoplias aff. malabaricus foi investigada. Os juvenis foram submetidos aos tratamentos FSP e Controle durante 28 dias, e adultos de matogrosso Hyphessobrycon eques foram oferecidos diariamente como presa para cada predador. O total de presas consumidas variou de 16 a 86 indivíduos. Apesar do menor consumo inicial de presas sob exposição de FSP, não houve diferenças significativas nas taxas de consumo entre os dois tratamentos. A FSP teve um efeito negativo no crescimento em tamanho de juvenis de H. aff. malabaricus. Embora a ausência de efeito no consumo de presas sugira uma relativa resistência de H. aff. malabaricus à exposição à FSP, o menor crescimento em tamanho dos indivíduos expostos ao poluente reflete possivelmente custos metabólicos. As implicações dos principais resultados nos níveis do organismo e da cadeia alimentar são discutidos, incluindo aspectos comportamentais e o papel desempenhado por este predador em ecossistemas aquáticos rasos.
Asunto(s)
Animales , Characiformes/fisiología , Conducta Alimentaria/efectos de los fármacos , Petróleo/efectos adversos , Contaminantes Químicos del Agua/efectos adversos , Characiformes/crecimiento & desarrolloAsunto(s)
Algoritmos , Donantes de Sangre , Selección de Donante/métodos , Sífilis/sangre , Adolescente , Adulto , Anciano , Brasil , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
OBJECTIVES: The aim of this work is to provide the first report of a transfusion-acquired HIV-1 infection and to verify transmission from the donor to the recipients using phylogenetic analysis of HIV-1 DNA sequences in a Brazilian blood bank. BACKGROUND: Although haemovigilance procedures based on phylogenetic analysis of HIV have been reported in several countries, this type of study has yet to be conducted in Latin America. MATERIALS AND METHODS: Upon identifying a HIV-1-positive repeat blood donor by enzyme immunoassay (EIA) blood screening, all recipients of the donor's previous donation were identified and tested for HIV-1 by EIA, nucleic acid amplification test and HIV-1 DNA sequencing and phylogenetic analysis. RESULTS: One of the recipients tested positive for HIV-1. The phylogenetic analysis showed a high genetic similarity among the viruses, thus supporting the hypothesis of transmission from the donor to the recipient. CONCLUSIONS: Phylogenetic analysis of HIV-1 DNA sequences has been a decisive tool in verifying suspected transmission of the virus from blood donor to recipient in Brazil.
Asunto(s)
Bancos de Sangre , Donantes de Sangre , Seguridad de la Sangre , Transfusión Sanguínea , Patógenos Transmitidos por la Sangre , ADN Viral/genética , Infecciones por VIH , VIH-1/genética , Filogenia , Adulto , Brasil , Femenino , Infecciones por VIH/genética , Infecciones por VIH/transmisión , HumanosRESUMEN
The family of ADAM (a disintegrin and metalloproteinase) proteins has been implicated in tumor initiation and progression. ADAM17/tumor necrosis factor-α (TNFα)-converting enzyme (TACE) has been initially recognized to release TNFα as well as its receptors (TNFRs) from the membrane. ADAM17, TNFα and TNFR have been found upregulated in cancer patients, although the underlying mechanisms remain largely unknown. As hypoxia is a hallmark of cancer that can lead to severe stress conditions accumulating in endoplasmic reticulum (ER) stress and the unfolded protein response (UPR), we investigated the role of these stress conditions in the regulation of ADAM17 and release of TNFR1.We found that severe hypoxia induced ADAM17 expression and activity. Although hypoxia-inducible factor 1α (HIF1α) was important to maintain basal ADAM17 mRNA levels during moderate hypoxia, it was not sufficient to induce ADAM17 levels under severe hypoxia. Instead, we found that ADAM17 induction by severe hypoxia can be mimicked by ER stressors such as Thapsigargin and occurs as a consequence of the activation of the PERK/eIF2α/ATF4 and activating transcription factor 6 (ATF6) arms of UPR in several tumor cell lines. ADAM17 expression was also increased in xenografts displaying ER stress because of treatment with the vascular endothelial growth factor (VEGF) inhibitory antibody Bevacizumab. Additionally, severe hypoxia and ER stress activated ADAM17 and ectodomain shedding of TNFR1 involving mitogen-activated protein (MAP) kinases and reactive oxygen species (ROS). Collectively, these results show that ADAM17 is a novel UPR-regulated gene in response to severe hypoxia and ER stress, which is actively involved in the release of TNFR1 under these conditions. These data provide a novel link between severe hypoxic stress conditions and inflammation in the tumor environment.
Asunto(s)
Proteínas ADAM/biosíntesis , Estrés del Retículo Endoplásmico , Neoplasias/enzimología , Respuesta de Proteína Desplegada , Proteína ADAM17 , Factor de Transcripción Activador 4/metabolismo , Factor de Transcripción Activador 6/metabolismo , Animales , Anticuerpos Monoclonales Humanizados/farmacología , Bevacizumab , Hipoxia de la Célula , Línea Celular Tumoral , Inhibidores Enzimáticos/farmacología , Femenino , Humanos , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Sistema de Señalización de MAP Quinasas/efectos de los fármacos , Sistema de Señalización de MAP Quinasas/fisiología , Masculino , Ratones , Ratones SCID , Especies Reactivas de Oxígeno/metabolismo , Receptores Tipo I de Factores de Necrosis Tumoral/metabolismo , Tapsigargina/farmacologíaRESUMEN
The distribution limits in the Atlantic of Callorhinchus callorynchus (Callorhinchidae) and Odontesthes argentinensis (Atherinopsidae) are extended northwards to 22° 22' S and 22° 31' S, respectively, whereas that of Lile piquitinga (Clupeidae) is extended southwards to 22° 22' S. Their occurrence in the north of Rio de Janeiro State is discussed. Remarks on the osteology of O. argentinensis, and morphometric and meristic data of L. piquitinga, are also provided.
Asunto(s)
Peces , Animales , Océano Atlántico , Brasil , Ecosistema , Femenino , Peces/anatomía & histología , GeografíaRESUMEN
Raltegravir is a human immunodeficiency virus-1 (HIV-1) integrase strand transfer inhibitor metabolized by glucuronidation via UDP-glucuronosyltransferase 1A1 (UGT1A1). In this study, 30 subjects with a UGT1A1*28/*28 genotype (associated with decreased activity of UGT1A1) and 27 UGT1A1*1/*1 control subjects (matched by race, age, gender, and body mass index) received a single 400-mg dose of raltegravir after fasting. No serious adverse experiences were reported, and there were no discontinuations due to adverse experiences. The geometric mean ratio (GMR) (UGT1A1*28/*28 to UGT1A1*1/*1) and 90% confidence interval (CI) were 1.41 (0.96, 2.09) for raltegravir area under the concentration-time curve (AUC(0-infinity)), 1.40 (0.86, 2.28) for maximum plasma concentration (C(max)), and 1.91 (1.43, 2.55) for concentration at the 12-h time point (C(12 h)). No clinically important differences in time to maximum concentration (T(max)) or half-life were observed. Plasma concentrations of raltegravir are modestly higher in individuals with the UGT1A1*28/*28 genotype than in those with the UGT1A1*1/*1 genotype. This increase is not clinically significant, and therefore no dose adjustment of raltegravir is required for individuals with the UGT1A1*28/*28 genotype.
Asunto(s)
Glucuronosiltransferasa/genética , Inhibidores de Integrasa VIH/farmacocinética , Pirrolidinonas/farmacocinética , Adulto , Área Bajo la Curva , Femenino , Genotipo , Glucuronosiltransferasa/metabolismo , Semivida , Humanos , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Raltegravir PotásicoRESUMEN
Raltegravir is a novel human immunodeficiency virus-1 integrase inhibitor with potent in vitro activity (95% inhibitory concentration (IC95)=33 nM in 50% human serum). Three double-blind, randomized, placebo-controlled, pharmacokinetic, safety, and tolerability studies were conducted: (1) single-dose escalation study (10-1,600 mg), (2) multiple-dose escalation study (100-800 mg q12 h x 10 days), and (3) single-dose female study (400 mg). Raltegravir was rapidly absorbed with a terminal half-life (t1/2) approximately 7-12 h. Approximately 7-14% of raltegravir was excreted unchanged in urine. Area under the curve (AUC)(0-infinity) was similar between male and female subjects. After multiple-dose administration, steady state was achieved within 2 days; there was little to modest accumulation of raltegravir. Trough levels were >33 nM for dose levels of 100 mg and greater. Raltegravir is generally well tolerated at doses of up to 1,600 mg/day given for up to 10 days and exhibits a pharmacokinetic profile supportive of twice-daily dosing with multiple doses of 100 mg and greater achieving trough levels >33 nM.
Asunto(s)
Inhibidores de Integrasa VIH/administración & dosificación , Compuestos Orgánicos/administración & dosificación , Administración Oral , Adulto , Área Bajo la Curva , Método Doble Ciego , Esquema de Medicación , Femenino , Inhibidores de Integrasa VIH/efectos adversos , Inhibidores de Integrasa VIH/farmacocinética , Semivida , Humanos , Masculino , Tasa de Depuración Metabólica , Compuestos Orgánicos/efectos adversos , Compuestos Orgánicos/farmacocinética , Pirrolidinonas , Raltegravir Potásico , Valores de ReferenciaRESUMEN
OBJECTIVE: To investigate whether a bronchial blocker (BB) placed through a routinely used single-lumen tube (SLT) to achieve 1-lung ventilation is appropriate in patients undergoing a minimally invasive direct coronary artery bypass (MIDCAB) operation. DESIGN: Clinical trial. SETTING: University hospital. PARTICIPANTS: Patients scheduled for elective MIDCAB operation (n = 159). INTERVENTIONS: Group A was treated with a left-sided double-lumen tube (DLT) and served as the control group. Group B was intubated with a routinely used SLT in combination with a BB. MEASUREMENTS AND MAIN RESULTS: The following data were collected: (1) time required for placement of each tube, (2) ventilation pressures, (3) lung compliance, (4) dislocations of the DLT or BB, (5) effectiveness of lung collapse, and (6) PaO(2) and fraction of inspired oxygen. In 4 patients (4%) of group B, the BB could not be placed within an acceptable time so that 155 patients (50 patients in group A, 105 patients in group B) were statistically analyzed. Statistically significant differences during 1-lung ventilation were found for peak and mean inspiratory pressure (p < 0.001 and p < 0.05), dynamic and static lung compliance (p < 0.05), and dynamic lung compliance change (p < 0.01). No statistical significance was found for intubation time (p > 0.05) and PaO(2) and fraction of inspired oxygen (p > 0.05). Lung collapse was insufficient in 1 patient of group A (2%) and in 2 patients of group B (2%). CONCLUSION: To achieve 1-lung ventilation during a MIDCAB procedure, the use of a BB combined with an SLT is an appropriate technique as an alternative to the commonly used DLT.
Asunto(s)
Bronquios/cirugía , Puente de Arteria Coronaria , Procedimientos Quirúrgicos Mínimamente Invasivos , Ventiladores Mecánicos , Anciano , Diseño de Equipo , Femenino , Humanos , Intubación Intratraqueal/instrumentación , Rendimiento Pulmonar , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Procedimientos Quirúrgicos Torácicos , Resultado del TratamientoRESUMEN
BACKGROUND: Propofol-sufentanil anaesthesia has become popular during cardiac surgery for its titrability and short recovery time. Avoidance of awareness is a major goal during cardiac surgery. We therefore investigated the dose-response relationship of propofol and cortical responses (mid-latency auditory evoked potentials, MLAEP). METHODS: One hundred patients undergoing cardiac surgery were investigated. Basic anaesthesia was performed with sufentanil (4.5 microg kg(-1) h(-1)) / flunitrazepam (9 microg kg(-1) h(-1)) infusion (control group); the other groups received in addition a loading dose of propofol 2 mg kg(-1) and a maintainance infusion of 1-3.5 mg kg(-1) h(-1). MLAEP were evaluated by using Pa/Nb-amplitudes and Nb-latencies. Haemodynamics were monitored by ECG, arterial blood pressure and cardiac function with pulmonary artery catheterization. RESULTS: In the control group, median amplitude of MLAEP decreased by 50% with a wide range, but were detectable in >90% of patients throughout surgery. Propofol suppressed amplitude Pa/Nb of MLAEP dose dependently. With 3.5 mg kg(-1) h(-1) amplitudes disappeared in >40% of patients throughout cardiac surgery. Median Nb-latencies increased in the control group from 44 to a range from 50 to 60 ms. In groups with propofol >2 mg kg(-1) h(-1), Nb-latencies, detectable in the patients without complete suppression of MLAEP, increased to median 60 ms. Haemodynamic parameters and cardiac function did not differ among the groups. The use of vasopressors was not increased even with the highest propofol dose used. CONCLUSION: The dose-response effect of propofol on auditory evoked potentials reveals that combining a loading dose of 2 mg kg-1 with a consecutive infusion of 3.5 mg kg(-1) h(-1) significantly suppresses MLAEP during cardiac surgery. Thus, auditory information may not be processed and awareness with recall becomes unlikely.
Asunto(s)
Anestésicos Intravenosos/farmacología , Procedimientos Quirúrgicos Cardíacos , Potenciales Evocados Auditivos/efectos de los fármacos , Propofol/farmacología , Adolescente , Adulto , Anciano , Relación Dosis-Respuesta a Droga , Hemodinámica/efectos de los fármacos , Humanos , Persona de Mediana EdadRESUMEN
Because of the restricted freedom of movement inherent in endoscopic standard instruments wholly endoscopic heart surgery has not been possible up to now. The development of such techniques was especially hindered by the rib cage. Now the precision which is imperative for bypass surgery or valve reconstruction is made possible by telemanipulator systems. Preconditions for this method are cardiopulmonary bypass-techniques which allow a cardioplegic cardiac arrest with closed chest and extensive hemodynamic monitoring which enables the anesthesiologist to make exact diagnoses without having a direct view on the heart. After an extensive experimental phase a telemanipulation system is successfully in use since May 1998 in the Cardiac Center in Leipzig.
Asunto(s)
Anestesia , Robótica , Procedimientos Quirúrgicos Operativos/métodos , Procedimientos Quirúrgicos Cardíacos , HumanosRESUMEN
UNLABELLED: A computer aided monitor-data processing system (CAMP-System) was developed in order to get a consistent and comprehensive database which can very precisely reflect intra-operative haemodynamic courses. The goal of the present study was to introduce a new method to scan and to gauge haemodynamic courses and to demonstrate its superiority over the traditional way of data processing based on a handwritten anaesthesia protocol. METHODS: The computerized system was applied to a study which was designed to investigate the influence of ketanserin (K) vs. urapidil (U) on haemodynamic stability during cardiac operations. Twenty male patients scheduled for myocardial revascularization received either 20 mg K or 30 mg U. Heart rate, central venous, arterial and pulmonary artery pressures were measured and on-line recorded every 20 seconds by the computer record system. In the handwritten protocol these variables were registered at eight pre-defined time points. Computerized data processing (including artifact depletion and data condensation) was compared to the results evaluated from the handwritten protocol. RESULTS: While the only significant differences in the handwritten protocol were slightly higher values of pulmonary artery pressures in group K, the computer analysis revealed a number of further differences. Higher maximum and a less stable time course of HR in group K in the pre-bypass phase and lower mean and standard deviation of MAP during cardiopulmonary bypass. CONCLUSION: Computerized data processing including automatic artifact suppression and data condensation was able to reveal differences in the course of haemodynamic variables that cannot be detected in a conventional handwritten protocol.