Association between myocardial mechanical dispersion and ventricular arrhythmogenicity in chagas cardiomyopathy.

Chagas disease is a major health concern in Latin America. Ventricular arrhythmia (VA) is a hallmark of Chagas cardiomyopathy (CCM), associated with worse prognosis. The present study aimed to verify the association between myocardial mechanical dispersion (MD) and ventricular arrhythmogenicity in CCM. In a cross-sectional study, 77 patients (55.8 ± 10.4 years) with CCM were evaluated. Global longitudinal strain (GLS) and MD were assessed by echocardiography, derived from the speckle tracking technique. Myocardial MD was measured from the onset of the Q/R wave on electrocardiogram to the peak longitudinal strain in 16 segments of the left ventricle. Frequency and complexity of ventricular extrasystoles (VES) were assessed by dynamic electrocardiography. The density and complexity of VES and the presence of non-sustained ventricular tachycardias (NSVTs) increase as MD increases. In logistic regression, MD was the only variable associated with the presence of paired VES and ventricular bigeminy. In addition, both MD and GLS were associated with the presence of NSVT (both, p < 0.01), and MD was independently associated with NSVT (OR 1.04, 95% CI 1.004-1.201, p = 0.031). In CCM, MD is associated with a higher density and complexity of VES, including NSVT.

Inflammatory biomarkers in infective endocarditis: machine learning to predict mortality.

Infective endocarditis (IE) is the cardiac disease with the highest rates of mortality. New biomarkers that are able to identify patients at risk for death are required to improve patient management and outcome. This study aims to investigate if cytokines, chemokines and growth factors measured at IE diagnosis can predict mortality. Patients with definite IE, according to the Duke's modified criteria, were included. Using high-performance Luminex assay, 27 different cytokines, chemokines and growth factors were analyzed. Machine learning techniques were used for the prediction of death and subsequently creating a decision tree, in which the cytokines, chemokines and growth factors were analyzed together with C-reactive protein (CRP). Sixty-nine patients were included, 41 (59%) male, median age 54 [interquartile range (IQR) = 41-65 years] and median time between onset of the symptoms and diagnosis was 12 days (IQR = 5-30 days). The in-hospital mortality was 26% (n = 18). Proinflammatory cytokines interkeukin (IL)-15 and C-C motif chemokine ligand (CCL4) were found to predict death, adding value to CRP levels. The decision tree predicted correctly the outcome of 91% of the patients at hospital admission. The high-risk group, defined as CRP ≥ 72 mg/dL, IL-15 ≥ 5·6 fg/ml and CCL4 ≥ 6·35 fg/ml had an 88% in-hospital mortality rate, whereas the patients classified as low-risk had a mortality rate of 8% (P = < 0·001). Cytokines IL-15 and CCL4 were predictors of mortality in IE, adding prognostic value beyond that provided by CRP levels. Assessment of cytokines has potential value for clinical risk stratification and monitoring in IE patients.

Eficiência de óleos essenciais na qualidade sanitária e fisiológica em sementes de feijão-fava (Phaseolus lunatus L. ) / Efficiency of essential oils in the sanitary and physiological quality of lima bean seeds (Phaseolus lunatus L. )

RESUMO A espécie Phaseolus lunatus L., conhecida popularmente como feijão-fava constitui uma das alternativas de renda e alimentação para a população da região Nordeste do Brasil. Um dos problemas enfrentados são as doenças que provocam grandes perdas na produção de sementes. O presente trabalho objetivou avaliar a eficiência dos óleos essenciais de copaíba, cravo-da-índia e manjericão na redução da incidência de fungos associados às sementes de feijão-fava, e sua interferência na qualidade fisiológica. Os tratamentos foram constituídos por óleos essenciais de copaíba, cravo-da-índia e manjericão nas concentrações de 0; 1; 1,5 e 2 mL. L-1 e fungicida (Captan®). Foram utilizadas 200 sementes por tratamento. Para análise da qualidade sanitária das sementes foi adotado o método de incubação em placas de Petri contendo dupla camada de papel-filtro umedecida com ADE, sob temperatura de 20 ±2 ºC, por 7 dias. A qualidade fisiológica das sementes foi determinada com base nos testes de germinação, emergência e vigor das sementes. Para o teste germinação foi empregado método de rolo de papel germitest e na emergência osemeio foi realizado em bandejas plásticas contendo areia lavada esterilizada, em condição de casa de vegetação, e após 9 dias da instalação foi determinado o vigor com base nos resultados de índice de velocidade de germinação e emergência; comprimento da parte aérea, raiz primária e plântula; e teor de massa seca da partes aérea, raízes e plântulas de feijão-fava. O delineamento experimental foi interiamente casualizados, em esquama de fatorial simples (3x4)+1 (óleos essenciais x concentrações + fungicida), com quatro repetições de 50 sementes. Os óleos essenciais de copaíba e manjericão reduziram consideravelmente o percentual de incidência dos fungos associados as sementes de feijão-fava. O óleo essencial de cravo-da-índia na concetração de 2 mL. L-1, reduziu a qualidade fisiológica das sementes de feijão-fava.

ABSTRACT The Phaseolus lunatus L. species, popularly known as lima bean, is one of the alternative sources of income and food for the population of Northeast Brazil. One of the problems is the diseases that cause great losses in seed production. This study evaluated the effectiveness of essential oils of copaiba, clove, and basil in reducing the incidence of fungi associated with lima bean seeds, as well as the effect on their physiological quality. The treatments consisted of essential oils of copaiba, clove, and basil at concentrations of 0; 1; 1.5; and 2 mL. L-1 and fungicide (Captan®). A total of 200 seeds were used per treatment. To analyze the sanitary quality of the seeds, the method used was incubation in petri dishes containing a double layer of filter paper moistened with distilled sterilized water at a temperature of 20 ± 2°C, for seven days. The physiological quality of the seeds was determined by testing their germination, emergence, and vigor. For the germination test, the method used was a roll of Germitest paper. For the emergence, the seeds were sown in plastic trays containing washed sterilized sand in greenhouse conditions. After nine days, the vigor was determined based on the results of germination and emergence speed rates; length of the aerial part, primary root, and seedling; and dry matter content of the aerial part, roots, and seedlings of the lima beans. The experimental design was completely randomized in a simple factorial arrangement (3x4)+1 (essential oils x concentrations + fungicide) with four replications of 50 seeds. The essential oils of copaiba and basil considerably reduced the percentage of incidence of the fungi associated with lima bean seeds. The essential clove oil at 2 mL. L-1 reduced the physiological quality of the lima bean seeds.

Reversible dilated cardiomyopathy associated with amphotericin B therapy.

WHAT IS KNOWN AND OBJECTIVE: Amphotericin B (AmB) is commonly used to treat a broad spectrum of fungal infections and leishmaniasis. Its use is limited by numerous adverse effects. Reversible dilated cardiomyopathy associated with AmB is a rare disorder with only four previously reported cases, and all of them referring to patients who presented with a predisposing factor for heart failure. CASE SUMMARY: A previously healthy 45-year-old man with visceral leishmaniasis treated with AmB developed acute dilated cardiomyopathy. Other causes of heart failure as well-known predisposing factors for this condition were ruled out. As with previously reported cases, the cardiac function of our patient returned to normal shortly after. WHAT IS NEW AND CONCLUSION: We describe the first case of dilated cardiomyopathy associated with the administration of AmB in a patient without any known predisposing factor for developing cardiac dysfunction. Available evidence suggests that AmB may induce cardiotoxicity. Further investigations are needed to clarify this issue.

Foxp3+CD25(high) CD4+ regulatory T cells from indeterminate patients with Chagas disease can suppress the effector cells and cytokines and reveal altered correlations with disease severity.

Immunoregulatory mechanisms are important to control the intense immune activity induced in Chagas disease. We evaluated the phenotypic profile and the mechanisms by which Treg cells function in patients with the indeterminate (IND) and cardiac (CARD) clinical forms of Chagas disease. The frequency of Foxp3(+)CD25(high) CD4(+)-T cells is augmented and correlated with the maintenance of a better cardiac function in IND. Treg cells from IND present suppressive activity, although the mechanism is not IL-10 or CTLA-4 dependent and are able to produce augmented levels of IL-17, IL-10 and granzyme B being its frequency correlated with percentage of Annexin V(+) CD4(+)-cells. In contrast, CARD presents higher frequency of IL-6(+), IFN-gamma(+), TNF-alpha(+) and CTLA-4(+) Treg-cells than IND. Thus, our data suggest that Treg cells have an important role in controlling the exacerbated immune response and morbidity in Trypanosoma cruzi infection, probably modulating the cytokine environment and/or killing effector cells.

Influence of low birth weight on microalbuminuria and blood pressure of school children.

UNLABELLED: Low birth weight (LBW) is associated to an increased incidence of hypertension, renal and cardiovascular diseases in adulthood. The objective of this study was to evaluate possible changes in microalbuminuria (MA) and blood pressure (BP) in children with LBW. MATERIAL AND METHODS: The birth weight (BW) of 1,049 children between 8 and 11 years of age, enrolled in schools in the city of Goiânia/Brazil was investigated. Those in the LBW group (BW < or = 2.5 kg) were compared to a similar group with normal birth weight - NBW (BW > or = 3.0 kg). BP and 24-hour urine MA were evaluated. BW and prematurity (gestational age < 37 weeks) were obtained from the information contained in the children's card. RESULTS: There were 34 children with LBW and 34 with NBW. No significant difference was found regarding age, sex, race, weight, height, BMI, and family history of hypertension or diabetes. Children with LBW presented higher systolic BP (p = 0.019) and more albumin in the 24-hour urine then children with NBW (p = 0.024). CONCLUSION: We concluded that school children with LBW present with higher BP and more albumin excretion in the 24-hour urine. These findings can indicate presence of changes in both blood pressure and microalbuminuria in prepubertal children with low birth weight..