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1.
Sci Total Environ ; 912: 169387, 2024 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-38110100

RESUMEN

Coniferous forests contribute to the European economy; however, they have experienced a decline since the late 1990s due to an invasive pest known as the pine processionary moth, Thaumetopoea pityocampa. The impacts of this pest are increasingly exacerbated by climate change. Traditional control strategies involving pesticides have had negative effects on public health and the environment. Instead, forest managers seek a more ecological and sustainable approach to management that promotes the natural actions of pest control agents. This study aims to evaluate the role of bats in suppressing pine processionary moths in pine forests and examine how the bat community composition and abundance influence pest consumption. Bats were sampled in the mountainous environment of the Serra da Estrela in central Portugal to collect faecal samples for DNA meta-barcoding analysis. We assessed the relationship between a) bat richness, b) bat relative abundance, c) bat diet richness, and the frequency of pine processionary moth consumption. Our findings indicate that sites with the highest bat species richness and abundance exhibit the highest levels of pine processionary moth consumption. The intensity of pine processionary moth consumption is independent of insect diversity within the site. The highest occurrence of pine processionary moth presence in bat diets is primarily observed in species that forage in cluttered habitats. A typical predator of pine processionary moths among bats is likely to be a forest-dwelling species that specialises in consuming Lepidoptera. These species primarily use short-range echolocation calls, which are relatively inaudible to tympanate moths, suitable for locating prey in cluttered environments, employing a gleaning hunting strategy. Examples include species from the genera Plecotus, Myotis, and Rhinolophus. This study enhances our understanding of the potential pest consumption services provided by bats in pine forests. The insights gained from this research can inform integrated pest management practices in forestry.


Asunto(s)
Quirópteros , Mariposas Nocturnas , Animales , Ecosistema , Conducta Predatoria , Bosques
2.
Mar Environ Res ; 168: 105307, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33984550

RESUMEN

Kelps are canopy-forming brown seaweed sustaining critical ecosystem services in coastal habitats, including shelter, nursery grounds, and providing food resources to a myriad of associated species. This study modeled the fundamental niche of Laminaria abyssalis along the Brazilian continental margin, an endemic species of the South Atlantic, to anticipate potential distributional range shifts under two contrasting scenarios of future environmental changes (RCP2.6 and RCP8.5). The model for fundamental niche predictions considering the "present scenario" has shown a wider potential area than the realized niche (i.e., the area where the species actually occurs) along the Brazilian coast. In both future scenarios, the models have shown niche erosion on the northern portion of the Brazilian coast and niche gains towards the south. In both scenarios, L. abyssalis populations tend to shift to deeper regions of the reef. The restricted range of occurrence (33,000 km2), intense anthropic activities along these beds (e.g., trawling fisheries, oil/gas mining, or removal for agricultural purposes) acting synergically with global warming, may drive this ecosystem to collapse faster than kelp species' ability to adapt. We propose to classify L. abyssalis as Endangered - (EN) under IUCN criteria, and highlight that long-term monitoring of kelp beds is an urgent need to develop effective conservation initiatives to protect such rare and invaluable ecosystem.


Asunto(s)
Kelp , Brasil , Ecosistema , Explotaciones Pesqueras , Calentamiento Global
4.
Sci Total Environ ; 676: 455-468, 2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-31048175

RESUMEN

Rhodolith beds, like many other marine ecosystems, are affected by climate change that is causing an increase in the magnitude and frequency of extreme high temperature events (heat waves). Unfortunately, this does not represent the sole peril for these communities, as coastal urbanization in conjunction with altered precipitation patterns can increase terrestrial-derived nutrient input. In Brazil, rhodolith beds are among the most extensive coastal benthic ecosystems, but despite their vast distribution and great ecological and economic importance, studies on the productivity of these communities and the impact of changing environmental conditions are almost non-existent. This study addressed the individual and combined effects of increases in temperature and nutrient concentration on the physiological performance of two widely distributed rhodolith species, Lithothamnion crispatum and Melyvonnea erubescens. The results showed species-specific responses in net photosynthetic performance, with no response in L. crispatum, while M. erubescens responded negatively to both increase in temperature and nutrients. In contrast, calcification in both species showed a significant decline at high temperature. No interactive effects were found between temperature and nutrients, yet their combined negative effects were additive, resulting in negative daily-integrated net productivity and a large decline in daily carbonate production in both species. This has strong implications for rhodolith bed primary productivity and carbonate production, as heat waves may potentially cause a strong decline in carbonate production (ca. 50% loss), accompanied by a severe drop in primary productivity that will be even more pronounced under high-nutrient conditions. Also, the species-specific responses to changes in temperature and nutrient concentration suggest that the magnitude of impact of these factors on rhodolith bed productivity will depend on the species dominating the community and may finally result in changes in rhodolith community composition.


Asunto(s)
Cambio Climático , Ecosistema , Rhodophyta/fisiología , Brasil , Carbonatos , Monitoreo del Ambiente , Concentración de Iones de Hidrógeno , Nitrógeno/análisis , Océanos y Mares , Fósforo/análisis , Fotosíntesis , Agua de Mar/química , Temperatura
5.
Rev Port Pneumol (2006) ; 22(5): 273-8, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27142810

RESUMEN

Children may benefit from minimally invasive surgery (MIS) in the correction of Morgagni hernia (MH). The present study aims to evaluate the outcome of MIS through a multicenter study. National institutions that use MIS in the treatment of MH were included. Demographic, clinical and operative data were analyzed. Thirteen patients with MH (6 males) were operated using similar MIS technique (percutaneous stitches) at a mean age of 22.2±18.3 months. Six patients had chromosomopathies (46%), five with Down syndrome (39%). Respiratory complaints were the most common presentation (54%). Surgery lasted 95±23min. In none of the patients was the hernia sac removed; prosthesis was never used. In the immediate post-operative period, 4 patients (36%) were admitted to intensive care unit (all with Down syndrome); all patients started enteral feeds within the first 24h. With a mean follow-up of 56±16.6 months, there were two recurrences (18%) at the same institution, one of which was repaired with an absorbable suture; both with Down syndrome. The application of MIS in the MH repair is effective even in the presence of comorbidities such as Down syndrome; the latter influences the immediate postoperative recovery and possibly the recurrence rate. Removal of hernia sac does not seem necessary. Non-absorbable sutures may be more appropriate.


Asunto(s)
Hernias Diafragmáticas Congénitas/cirugía , Herniorrafia/métodos , Preescolar , Estudios Transversales , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Procedimientos Quirúrgicos Mínimamente Invasivos , Estudios Retrospectivos
7.
PLoS One ; 10(6): e0127176, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26061735

RESUMEN

The Southwestern Atlantic harbors unique and relatively understudied reef systems, including the only atoll in South Atlantic: Rocas atoll. Located 230 km off the NE Brazilian coast, Rocas is formed by coralline red algae and vermetid mollusks, and is potentially one of the most "pristine" areas in Southwestern Atlantic. We provide the first comprehensive and integrative description of the fish and benthic communities inhabiting different shallow reef habitats of Rocas. We studied two contrasting tide pool habitats: open pools, which communicate with the open ocean even during low tides, thus more exposed to wave action; and closed pools, which remain isolated during low tide and are comparatively less exposed. Reef fish assemblages, benthic cover, algal turfs and fish feeding pressure on the benthos remarkably varied between open and closed pools. The planktivore Thalassoma noronhanum was the most abundant fish species in both habitats. In terms of biomass, the lemon shark Negaprion brevirostris and the omnivore Melichtys niger were dominant in open pools, while herbivorous fishes (mainly Acanthurus spp.) prevailed in closed pools. Overall benthic cover was dominated by algal turfs, composed of articulated calcareous algae in open pools and non-calcified algae in closed pools. Feeding pressure was dominated by acanthurids and was 10-fold lower in open pools than in closed pools. Besides different wave exposure conditions, such pattern could also be related to the presence of sharks in open pools, prompting herbivorous fish to feed more in closed pools. This might indirectly affect the structure of reef fish assemblages and benthic communities. The macroalgae Digenea simplex, which is uncommon in closed pools and abundant in the reef flat, was highly preferred in herbivory assays, indicating that herbivory by fishes might be shaping this distribution pattern. The variations in benthic and reef fish communities, and feeding pressure on the benthos between open and closed pools suggest that the dynamics in open pools is mostly driven by physical factors and the tolerance of organisms to harsh conditions, while in closed pools direct and indirect effects of species interactions also play an important role. Understanding the mechanisms shaping biological communities and how they scale-up to ecosystem functioning is particularly important on isolated near-pristine systems where natural processes can still be studied under limited human impact.


Asunto(s)
Arrecifes de Coral , Ecosistema , Conducta Alimentaria , Peces/fisiología , Animales , Océano Atlántico , Brasil , Presión
8.
Mar Pollut Bull ; 64(11): 2380-90, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23010654

RESUMEN

Urbanization leads to the expansion of ephemeral seaweed species and the decline of important perennial, canopy-forming seaweed species. Understanding the mechanisms that lead to these changes is a current challenge. In the present study, laboratory assays and field transplantations were performed with two seaweed species: the perennial, canopy-forming seaweed Sargassum stenophyllum and the ephemeral seaweed Ulva lactuca. Photosynthetic efficiency was assessed using modulated chlorophyll fluorometry. Brief exposure to urban waters does not appear to be a major stressor to the photosynthetic efficiency of either species. However, after 26 days of transplantation in urban waters, S. stenophyllum declined, whereas U. lactuca had enhanced photosynthetic efficiency. This difference reflects their divergent abilities to regulate the energy distribution at the PSII and shows that urban stressors alter these mechanisms. Our results provide evidence of the physiological causes for the decline of Sargassum species and the expansion of Ulva species in impacted urban areas.


Asunto(s)
Adaptación Fisiológica/fisiología , Fotosíntesis/fisiología , Algas Marinas/fisiología , Clorofila/metabolismo , Ecosistema , Monitoreo del Ambiente , Fotosíntesis/efectos de los fármacos , Urbanización
9.
J Fish Biol ; 79(7): 1984-2006, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22141900

RESUMEN

The community structure of the reef fish fauna of Trindade Island, a volcanic oceanic island located 1160 km off the coast of Brazil, is described based on intensive visual censuses. Seventy-six species were encountered in 252 censuses, with mean ± S.E. of 99 ± 3 individuals and 15.7 ± 0.3 species 40 m(-2) transect. The average fish biomass, calculated from length-class estimation, was 22.1 kg 40 m(-2) transect. The species contributing most to biomass were, in decreasing order, Melichthys niger, Cephalopholis fulva, Kyphosus spp., Holocentrus adscensionis, Sparisoma amplum, Sparisoma axillare, Acanthurus bahianus and Epinephelus adscensionis. Carnivorous fishes were the largest trophic group in terms of biomass, followed by omnivores and roving herbivores. The two predominant types of reef habitat, fringing reefs built by coralline algae and rocky reefs made of volcanic boulders, showed significant differences in the biomass and the abundance of the trophic guilds. Within each habitat type, significant differences in species richness, density and biomass were detected among crest, slope and interface zones. Although similar in overall species composition to coastal reefs in Brazil, the fish fauna of Trindade Island shares certain characteristics, such as a high abundance of planktivores, with other Brazilian oceanic islands. Despite comparatively high fish biomass, including the macro-carnivorous species habitually targeted by fisheries, signs of overfishing were evident. These findings highlight the urgency for a conservation initiative for this isolated, unique and vulnerable reef system.


Asunto(s)
Biodiversidad , Peces/fisiología , Clima Tropical , Animales , Océano Atlántico , Ecosistema , Geografía , Densidad de Población
12.
Arq. bras. cardiol ; 69(3): 175-9, set. 1997. tab, graf
Artículo en Portugués | LILACS | ID: lil-234338

RESUMEN

OBJETIVO - Analisar a perda do diâmetro luminal mínimo (DLM) nos primeiros 15 min após angioplastia coronária por balão (AC), quantificando sua influência na reestenose coronária. MÉTODOS - Foram estudadas, prospectivamente, 86 AC em 86 pacientes. Os pacientes foram divididos em dois subgrupos de acordo com apresença ou ausência de reestenose; o 1o. grupo compreendendo as 31 lesöes com reestenose e o 2o. as 55 lesöes sem reestenose. RESULTADOS - A análise univariada mostrou que a relação balão/artéria foi menor no grupo com reestenose (0,92ñ0,01 vs 1,00ñ0,11, P=.003). O grupo com reestenose apresentou maior recolhimento elástico absoluto e relativo no 1o. min (0,79ñ0,54 vs 0,68ñ0,59mm; P=0,007 e 32,04ñ14,27 vs 22,15ñ16,25 por cento; P=0,006.) e no controle angiográfico do 15o. min (1,25ñ0,59 vs 0,90ñ0,65mm, P=0,017 e 46,75ñ15,69 vs 29,18ñ17,84 por cento , P<0,00001)do que o grupo sem reestenose. O DLM no 1o. min foi menor no grupo com reestenose (2,15ñ0,42 vs 2,43ñ0,58mm; P=0,002). O grupo com reestenose apresentou uma maior perda precoce no DLM (0,46ñ0,34 vs 0,22ñ0,35mm, P=0,004). Este decréscimo na luz do vaso determinou que o DLM do 15o. min fosse ainda menor no grupo com reestenose (1,69ñ0,48 vs 2,20ñ0,61; P=0,0001). Da análise multivariada, entretanto, identificou-se apenas a relação balão/artéria e o DLM do 15o. min como os dois fatores independentes mais relacionados à reestenose. CONCLUSÄO - O recolhimento elástico e a perda do DLM ao longo dos 15 min são fatoes diretamente relacionados à reestenose.Entretanto, a análise multivariada mostrou que a relação balão/artéria e o DLM de 15 min são os dois fatores independentes mais fortemente preditores de reestenose.


Asunto(s)
Humanos , Masculino , Anciano , Angioplastia Coronaria con Balón , Prueba de Esfuerzo , Cintigrafía , Cateterismo , Cuidados Posoperatorios , Factores de Tiempo
13.
Arq Bras Cardiol ; 69(3): 175-9, 1997 Sep.
Artículo en Portugués | MEDLINE | ID: mdl-9595729

RESUMEN

PURPOSE: To evaluate the early luminal diameter loss in the first 15 min after percutaneous transluminal coronary angioplasty (PTCA) and its influence on coronary restenosis. METHODS: In a prospective study, we evaluated 86 patients. The patients were divided in two groups based on the presence or absence of coronary restenosis. Thirty one lesions developed restenosis and 55 lesions did not. RESULTS: Univariate analysis showed that balloon/artery ratio was lower in the group of restenosis (0.92 +/- 0.01 vs 1.00 +/- 0.11, P = .003). Absolute and relative elastic recoil at 1 min was greater in the group that developed restenosis (0.79 +/- 0.54 vs 0.68 +/- 0.59 mm; P = .007 and 32.04 +/- 14.27 vs 22.15 +/- 16.65%; P = .006). Similarly, absolute and relative elastic recoil at 15 min were greater in the group with restenosis (1.25 +/- 0.59 vs 0.90 +/- 0.65 mm, P = .017 e 46.75 +/- 15.69 vs 29.18 +/- 17.84%, P < .00001). Minimal luminal diameter (MLD) at 1 min was lower in the group with restenosis (2.15 +/- 0.42 vs 2.43 +/- 0.58 mm; P = .022). The very early loss was greater in the group with restenosis (0.46 +/- 0.34 vs 0.22 +/- 0.35 mm, P = .004). MLD at 15 min was lower in the group of restenosis than in the group without restenosis (1.69 +/- 0.48 vs 2.20 +/- 0.61; P = .0001). Multivariate analysis revealed balloon/artery ratio and MLD at 15 min as independent correlates of the late outcome. CONCLUSION: The late outcome of PTCA is influenced by elastic recoil and the early MLD loss after PTCA. However, the strongest and most important predictors of late outcome by multivariate analysis were balloon/artery ratio and MLD at 15 min.


Asunto(s)
Angioplastia Coronaria con Balón , Enfermedad Coronaria/terapia , Vasos Coronarios/patología , Angiografía Coronaria , Enfermedad Coronaria/etiología , Vasos Coronarios/lesiones , Vasos Coronarios/fisiopatología , Elasticidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estudios Prospectivos , Recurrencia , Factores de Tiempo
14.
Eur Heart J ; 17(8): 1175-80, 1996 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-8869858

RESUMEN

BACKGROUND: Whether myocardial ischaemia is the mechanism underlying chest pain in patients with angina and normal coronary arteriograms is controversial. We sought to detect the presence of transient myocardial ischaemia using continuous monitoring of coronary sinus blood pH during atrial pacing. METHODS AND RESULTS: We studied 14 patients (eight women, six men, mean age 51 +/- 3 years) with typical exertional angina and normal coronary arteriograms and nine patients with coronary artery disease (two men, seven women, mean age 61 +/- 7 years). Of the 14 patients with normal coronary arteries, eight had a reduced coronary blood flow reserve (< 2.5-fold increase), 11 had an ischaemic-appearing response to exercise testing, six had reversible perfusion detects on exercise thallium scans and one had resting left bundle branch block. All patients underwent continuous pH monitoring of coronary sinus blood at rest and during incremental atrial pacing (up to 160 bpm). Coronary sinus oxygen saturation and myocardial lactate extraction ratio were also evaluated at rest and at peak pacing. Eleven patients with angina and normal coronary arteries and eight with coronary artery disease had angina during pacing. Both patients with angina and normal coronary arteries (n = 13) and patients with coronary artery disease (n = 9) showed a fall in coronary sinus pH (-0.02 +/- 0.02 vs -0.11 +/- 0.03 pH units, respectively, P < 0.01). Coronary sinus oxygen saturation expressed as a percentage dropped by 19 +/- 6% in patients with coronary artery disease and by 6 +/- 2% in patients with angina and normal coronary arteriograms (P < 0.05). Myocardial lactate extraction ratio decreased from 33 +/- 6% to -1.4 +/- 4% in patients with coronary artery disease and from 23 +/- 8% to 20 +/- 8% in those with angina and normal coronary arteriograms. Three patients with angina and normal coronary arteries had a drop in coronary sinus pH > 0.02 pH units (-0.043 +/- 0.006 pH units) and in coronary sinus oxygen saturation > 8% (16 +/- 3%) consistent with myocardial ischaemia. CONCLUSION: Despite severe chest pain and reduced coronary flow reserve after pacing, most patients with angina and normal coronary arteriograms do not show metabolic evidence of myocardial ischaemia.


Asunto(s)
Vasos Coronarios/fisiología , Ácido Láctico/sangre , Angina Microvascular/fisiopatología , Isquemia Miocárdica/fisiopatología , Adulto , Velocidad del Flujo Sanguíneo , Cateterismo Cardíaco , Estimulación Cardíaca Artificial , Angiografía Coronaria , Electrocardiografía , Femenino , Humanos , Concentración de Iones de Hidrógeno , Masculino , Angina Microvascular/sangre , Angina Microvascular/diagnóstico por imagen , Persona de Mediana Edad , Isquemia Miocárdica/sangre , Isquemia Miocárdica/diagnóstico por imagen
15.
Eur J Pediatr Surg ; 5(5): 295-8, 1995 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-8555135

RESUMEN

The authors illustrate a case of right neonatal congenital diaphragmatic hernia (CDH) of Bochdalek with major pulmonary hypoplasia and postoperative massive mediastinal displacement to the right, leading to tracheal compression and recurrent respiratory distress at every attempt to wean the infant from the ventilator. Mediastinal stabilization was obtained by placing an expansion prosthesis (of the cutaneous type) in the right hemithorax, to prevent mediastinal obstruction of the main airways. This procedure may prove to be an original and efficient solution for the critical postoperative respiratory obstruction due to severe pulmonary hypoplasia and mediastinal mass effect in the newborn with CDH. However, this may not prevent progressive scoliosis, a serious problem frequently seen in the absence of one lung.


Asunto(s)
Hernia Diafragmática/cirugía , Hernias Diafragmáticas Congénitas , Pulmón/anomalías , Mediastino/cirugía , Prótesis e Implantes , Obstrucción de las Vías Aéreas/prevención & control , Hernia Diafragmática/complicaciones , Humanos , Recién Nacido , Masculino , Complicaciones Posoperatorias/prevención & control
16.
Circulation ; 92(3): 371-9, 1995 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-7634451

RESUMEN

BACKGROUND: Continuous intravenous administration of adenosine to humans often results in a paradoxical rise in pulmonary capillary wedge pressure (PCWP), whereas arterial resistance is lowered and cardiac output and heart rate increase. This is believed to be due to diastolic stiffening of the ventricle or to a negative inotropic effect. In the present study, we tested these and other mechanisms by using pressure-volume (PV) analysis and echocardiography. METHODS AND RESULTS: Fifteen patients with normal rest left ventricular function underwent cardiac catheterization and received adenosine at a rate of 140 micrograms/kg per minute IV for 6 to 10 minutes. PV relations were measured in 9 patients (without coronary artery disease) using the conductance catheter method. In 6 additional patients with coronary artery disease, echocardiograms were used to assess wall thickness and function, and aortic and coronary sinus blood, lactate, oxygen, and adenosine levels were measured. Adenosine increased PCWP by 19% (+2.6 mm Hg) in both patient groups while lowering arterial load by 30% and increasing cardiac output by 45% (all P < .001). There was no significant effect of adenosine on mean linear chamber compliance or monoexponential elastic stiffness, as the diastolic PV relation was unchanged in most patients. Diastolic wall thickness also was unaltered. Thus, the PCWP rise did not appear to be due to diastolic stiffening. Adenosine induced a rightward shift of the end-systolic PV relation (ESPVR) (+12.7 +/- 3.7 mL) without a slope change. This shift likely reflected effects of afterload reduction, as other indexes (stroke work-end-diastolic volume relation and dP/dtmax at matched preload) were either unchanged or increased. Furthermore, this modest shift in ESPVR was more than compensated for by vasodilation and tachycardia, so reduced systolic function could not explain the increase in PCWP. There also was no net lactate production to suggest ischemia. Rather than arising from direct myocardial effects, PCWP elevation was most easily explained by a change in vascular loading, as both left ventricular end-diastolic volume and right atrial pressure increased (P < .05). This suggests that adenosine induced a redistribution of blood volume toward the central thorax. CONCLUSIONS: PCWP elevation in response to adenosine primarily results from changes in vascular loading rather than from direct effects on cardiac diastolic or systolic function.


Asunto(s)
Adenosina/administración & dosificación , Presión Esfenoidal Pulmonar/efectos de los fármacos , Enfermedad Coronaria/fisiopatología , Ecocardiografía , Hemodinámica , Humanos , Pulmón/irrigación sanguínea
17.
Eur J Pediatr Surg ; 5(1): 43-7, 1995 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-7756236

RESUMEN

The authors report a case history of a male newborn at term, presenting with an accessory diaphragm in the right hemithorax, and an associated lung hypoplasia, revealed by a transient respiratory distress. The review of 31 cases published in the literature confirm the rare occurrence of this malformation. The diagnostic difficulties are discussed. The advantages of both MRI and CT scanning are compared. Pulmonary, vascular, or diaphragmatic abnormalities were due either to the isolated diagnosis or to its possible associated malformations. Operative management is often considered in view of the progressive respiratory complications. Excision of the accessory diaphragm does not necessarily solve the problem of a coexisting lung hypoplasia.


Asunto(s)
Diafragma/anomalías , Adulto , Broncografía , Niño , Preescolar , Anomalías Congénitas/cirugía , Diafragma/embriología , Diafragma/patología , Diafragma/cirugía , Femenino , Humanos , Lactante , Recién Nacido , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X
18.
Int J Cardiol ; 48(2): 163-6, 1995 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-7774995

RESUMEN

We studied the prevalence of lipid disorders and of coronary artery disease and the main factors affecting plasma lipids in a cohort of Brazilian hemodialysis patients. The investigation comprised 75 adult hemodialysis patients and 200 normal controls matched for age, sex, race and body mass index. Mean values for plasma lipids were within normal limits in the dialysis group. Total cholesterol (184 +/- 44 vs. 201 +/- 46 mg/dl), LDL (110 +/- 36 vs. 131 +/- 44 mg/dl) and HDL (40 +/- 13 vs. 47 +/- 12 mg/dl) were significantly lower in the dialysis patients (P < 0.01), whereas VLDL (32 +/- 14 vs. 21 +/- 12 mg/dl) and triglyceride (161 +/- 71 vs. 111 +/- 70 mg/dl) were increased (P < 0.01). Increased triglyceride was observed in 24% of the dialysis patients, a prevalence two to three times lower than that reported in the literature. In the dialysis group, the variables positively related to total cholesterol were hypertension (P < 0.05) and gender (female) (P < 0.05); to LDL and HDL, hypertension (P < 0.05 and P < 0.01, respectively); and to triglyceride, use of propranolol (P < 0.01). Age, race, duration of hemodialysis, body mass index and plasma creatinine did not affect plasma lipids. The prevalence of coronary artery disease, established by invasive and noninvasive methods, was 10.7% while in the literature 20-35% of the unselected hemodialysis patients present obstructive coronariopathy. We conclude that the plasma lipid profile of Brazilian hemodialysis patients is similar to those reported in American and European literature, whereas the prevalence of hypertriglyceridemia and of coronary artery disease appears to be reduced.


Asunto(s)
Colesterol/sangre , Enfermedad Coronaria/sangre , Fallo Renal Crónico/sangre , Lipoproteínas/sangre , Triglicéridos/sangre , Adulto , Anciano , Análisis de Varianza , Brasil , Estudios de Casos y Controles , Estudios de Cohortes , Enfermedad Coronaria/complicaciones , Enfermedad Coronaria/diagnóstico , Femenino , Humanos , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/terapia , Lipoproteínas HDL/sangre , Lipoproteínas LDL/sangre , Lipoproteínas VLDL/sangre , Masculino , Persona de Mediana Edad , Diálisis Renal
19.
Arq Bras Cardiol ; 62(4): 225-32, 1994 Apr.
Artículo en Portugués | MEDLINE | ID: mdl-7998848

RESUMEN

PURPOSE: To evaluate the success rate and complications, as well as the technical difficulties involved catheter laser coronary angioplasty, making evident the unsuccessful cases. METHODS: Twenty eight patients were treated with laser from August to November, 1993. The treatment was complemented with balloon angioplasty. Lesions were complex: 10 (36%) were type B and 18 (64%), type C. Concerning the obstruction grade, 18 (64%) were > or = 95%. Laser generator CVX 300(TM) Spectranectics as well as Extreme(TM) and Vitesse(TM) catheters with 1.4, 1.7 and 2.0mm in diameter, concentric and excentric, were used. Laser procedure success was defined as a reduction > 20% in the obstruction grade. The procedure success was attended when the residual stenosis was < 50% after a 15-minute observation, after balloon complementation. RESULTS: The unsuccess rate with laser catheter (Lc) was 34% (10 lesions) of which 3 cases were solved by other methods, 5 were not successful because of anatomic difficulties in surpassing the lesion and, in the two others the success criterium in the reduction of the obstruction grade of the coronary artery was not achieved, although the lesion surpassing was possible with the use of balloon catheter. The final success reached 89% (21 lesions). The procedure complications were a case of thrombosis, a perforation accompanied by a myocardial infarction and another myocardial infarction (non-Q wave), all with good outcome. CONCLUSION: The use of laser in the treatment of coronary artery obstructive lesions is a viable method. Nonetheless, more experience is necessary to demonstrate its actual value, optimizate the results and may be reduce restenosis rate.


Asunto(s)
Angioplastia Coronaria con Balón , Angioplastia de Balón Asistida por Láser , Enfermedad Coronaria/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Angioplastia Coronaria con Balón/efectos adversos , Angioplastia Coronaria con Balón/métodos , Angioplastia de Balón Asistida por Láser/efectos adversos , Angioplastia de Balón Asistida por Láser/métodos , Estudios de Evaluación como Asunto , Femenino , Humanos , Masculino , Persona de Mediana Edad
20.
Arq Bras Cardiol ; 60(5): 321-5, 1993 May.
Artículo en Portugués | MEDLINE | ID: mdl-8311748

RESUMEN

PURPOSE: To demonstrate the importance of the preservation of mitral annulus-chordae tendineae-papillary muscles continuity in mitral valve replacement. METHODS: We studied 21 patients who were submitted to mitral valve replacement, divided in two randomized groups: group 1, 12 cases who undergone mitral valve replacement, with preservation of the posterior leaflet and correspondent chordae tendineae; and group 2-9 cases who undergone conventional mitral valve replacement, excising the mitral valve apparatus. The left ventricular function was studied both, in the pre and post operative period, by echocardiography, cardiac catheterization, and radioisotopic study. The statistical analysis was done by the Wilcoxson's test. RESULTS: There were no early post operative deaths. Analyzing the results of the ejection fraction by the radioisotopic study we found a significant difference (p = 0.03) between the percentual decrease of the two groups. The results of the fractional shortening were higher in group 1 than in group 2, however not significant. The left ventricular diastolic diameters average was lower in group 1 than in group 2, so as the left atrium diameter. We found a decrease in left ventricular end-diastolic pressure in group 1, however there was an increase in group 2, by the cardiac catheterization. There was a proportional increase in group 1 both in lung artery and lung capillary pressures. There was a significant difference (p = 0.05) between the average values of right ventricular diastolic pressure. CONCLUSION: There is better preservation of left ventricular function in group 1.


Asunto(s)
Bioprótesis , Cuerdas Tendinosas/cirugía , Prótesis Valvulares Cardíacas , Insuficiencia de la Válvula Mitral/cirugía , Músculos Papilares/cirugía , Adulto , Presión Sanguínea , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Válvula Mitral/cirugía , Cuidados Posoperatorios , Cuidados Preoperatorios , Volumen Sistólico , Función Ventricular Izquierda
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