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1.
Water Res ; 246: 120691, 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37857005

RESUMO

Anthropogenic activities have led to excessive loading of phosphorus and nitrogen into water bodies, leading to eutrophication and promoting the growth of cyanobacteria, posing a threat to the health of humans and aquatic animals. Techniques such as Floc & Lock have been developed to mitigate eutrophication by reducing phosphorus concentrations in water and preventing algal blooms. However, little attention has been given to the impact of phosphorus resuspension by sediment-associated organisms such as benthic macroinvertebrates, on the effectiveness of this technique. Here, we experimentally evaluated whether the presence of snails Melanoides tuberculata (Müller, 1774) and larvae of Chironomus sancticaroli (Strixino and Strixino, 1981) affects the efficiency of the Floc & Lock technique. Snails and chironomid larvae are benthic macroinvertebrates commonly found in high abundance in eutrophic reservoirs. Specifically, we tested the hypotheses that (i) the presence of benthic macroinvertebrates reduces the efficiency of coagulants and clays in removing phosphorus and algal biomass from the water column, and (ii) this effect is species-dependent, as some organisms such as the snails, revolve the substrate and resuspend sedimented particles, while other ones, such as chironomid larvae, aid in the removal of phosphorus from the water column by depositing them in the sediment. Our findings revealed that the impact of benthic macroinvertebrates on the effectiveness of the Floc & Lock technique is species-dependent. Chironomid larvae positively influenced the efficiency of the technique by aiding in the removal of total phosphorus, soluble reactive phosphorus, and algal biomass from the water column, depositing them in the sediment. In contrast, the presence of snails had the opposite effect, resulting in increased phosphorus concentration and algal biomass in the water. Surprisingly, the snails consumed the flocs formed by the coagulant and clay within a short time interval of 72 h, raising concerns due to the presence of toxic cyanobacterial biomass in these flocs. Our study emphasizes the importance of considering benthic macroinvertebrates and their impact on the effectiveness of eutrophication management techniques.


Assuntos
Cianobactérias , Eutrofização , Animais , Humanos , Biomassa , Água , Fósforo , Lagos/química
2.
J Insect Physiol ; 151: 104573, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37838284

RESUMO

A detailed understanding of how host fitness changes in response to variations in microbe density (an ecological measure of disease tolerance) is an important aim of infection biology. Here, we applied dose-response curves to study Aedes aegypti survival upon exposure to different microbes. We challenged female mosquitoes with Listeria monocytogenes, a model bacterial pathogen, Dengue 4 virus and Zika virus, two medically relevant arboviruses, to understand the distribution of mosquito survival following microbe exposure. By correlating microbe loads and host health, we found that a blood meal promotes disease tolerance in our systemic bacterial infection model and that mosquitoes orally infected with bacteria had an enhanced defensive capacity than insects infected through injection. We also showed that Aedes aegypti displays a higher survival profile following arbovirus infection when compared to bacterial infections. Here, we applied a framework for investigating microbe-induced mosquito mortality and details how the lifespan of Aedes aegypti varies with different inoculum sizes of bacteria and arboviruses.


Assuntos
Aedes , Infecções por Arbovirus , Arbovírus , Vírus da Dengue , Infecção por Zika virus , Zika virus , Feminino , Animais , Vírus da Dengue/fisiologia , Mosquitos Vetores/microbiologia , Zika virus/fisiologia , Bactérias
3.
Stud Health Technol Inform ; 302: 382-383, 2023 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-37203696

RESUMO

Tracking and reporting Adverse Drug Reactions (ADRs) is crucial for patient safety. This work aims to improve the data quality of the SIRAI application in Portugal by developing data validation rules and a scoring system for each record and the overall dataset. The goal is to enhance the effectiveness of the SIRAI application in monitoring adverse drug reactions.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Farmacovigilância , Humanos , Sistemas de Notificação de Reações Adversas a Medicamentos , Portugal , Segurança do Paciente , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle
4.
J Anim Ecol ; 92(6): 1176-1189, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36994670

RESUMO

Human land-use change is a major threat to natural ecosystems worldwide. Nonetheless, the effects of human land-uses on the structure of plant and animal assemblages and their functional characteristics need to be better understood. Furthermore, the pathways by which human land uses affect ecosystem functions, such as biomass production, still need to be clarified. We compiled a unique dataset of fish, arthropod and macrophyte assemblages from 61 stream ecosystems in two Neotropical biomes: Amazonian rainforest and Uruguayan grasslands. We then tested how the cover of agriculture, pasture, urbanization and afforestation affected the taxonomic richness and functional diversity of those three species assemblages, and the consequences of these effects for animal biomass production. Single trait categories and functional diversity were evaluated, combining recruitment and life-history, resource and habitat-use, and body size. The effects of intensive human land-uses on taxonomic and functional diversities were as strong as other drivers known to affect biodiversity, such as local climate and environmental factors. In both biomes, the taxonomic richness and functional diversity of animal and macrophyte assemblages decreased with increasing cover of agriculture, pasture, and urbanization. Human land-uses were associated with functional homogenization of both animal and macrophyte assemblages. Human land-uses reduced animal biomass through direct and indirect pathways mediated by declines in taxonomic and functional diversities. Our findings indicate that converting natural ecosystems to supply human demands results in species loss and trait homogenization across multiple biotic assemblages, ultimately reducing animal biomass production in streams.


Assuntos
Artrópodes , Ecossistema , Humanos , Animais , Biomassa , Rios/química , Biodiversidade
5.
Nanoscale ; 15(2): 687-706, 2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36515425

RESUMO

Graphene-based materials (GBMs) have been investigated in recent years with the aim of developing flexible interfaces to address a range of neurological disorders, where electrical stimulation may improve brain function and tissue regeneration. The recent discovery that GBM electrodes can generate an electrical response upon light exposure has inspired the development of non-genetic approaches capable of selectively modulating brain cells without genetic manipulation (i.e., optogenetics). Here, we propose the conjugation of graphene with upconversion nanoparticles (UCNPs), which enable wireless transcranial activation using tissue-penetrating near-infrared (NIR) radiation. Following a design of experiments approach, we first investigated the influence of different host matrices and dopants commonly used to synthesize UCNPs in the electrical response of graphene. Two UCNP formulations achieving optimal enhancement of electrical conductivity upon NIR activation at λ = 780 or 980 nm were identified. These formulations were then covalently attached to graphene nanoplatelets following selective hydroxyl derivatization. The resulting nanocomposites were evaluated in vitro using SH-SY5Y human neuroblastoma cells. NIR activation at λ = 980 nm promoted cell proliferation and downregulated neuronal and glial differentiation markers, suggesting the potential application of GBMs in minimally invasive stimulation of cells for tissue regeneration.


Assuntos
Grafite , Nanopartículas , Neuroblastoma , Humanos , Neurônios , Neuroglia , Eletrodos
7.
J Anim Ecol ; 91(3): 551-565, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34954827

RESUMO

Under increasing nutrient loading, shallow lakes may shift from a state of clear water dominated by submerged macrophytes to a turbid state dominated by phytoplankton or a shaded state dominated by floating macrophytes. How such regime shifts mediate the relationship between taxonomic and functional diversities (FD) and lake multifunctionality is poorly understood. We employed a detailed database describing a shallow lake over a 12-year period during which the lake has displayed all the three states (clear, turbid and shaded) to investigate how species richness, FD of fish and zooplankton, ecosystem multifunctionality and five individual ecosystem functions (nitrogen and phosphorus concentrations, standing fish biomass, algae production and light availability) differ among states. We also evaluated how the relationship between biodiversity (species richness and FD) and multifunctionality is affected by regime shifts. We showed that species richness and the FD of fish and zooplankton were highest during the clear state. The clear state also maintained the highest values of multifunctionality as well as standing fish biomass production, algae biomass and light availability, whereas the turbid and shaded states had higher nutrient concentrations. Functional diversity was the best predictor of multifunctionality. The relationship between FD and multifunctionality was strongly positive during the clear state, but such relationship became flatter after the shift to the turbid or shaded state. Our findings illustrate that focusing on functional traits may provide a more mechanistic understanding of how regime shifts affect biodiversity and the consequences for ecosystem functioning. Regime shifts towards a turbid or shaded state negatively affect the taxonomic diversity and FD of fish and zooplankton, which in turn impairs the multifunctionality of shallow lakes.


Assuntos
Ecossistema , Lagos , Animais , Biomassa , Peixes , Fitoplâncton
8.
An Acad Bras Cienc ; 93(4): e20190868, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34586310

RESUMO

Ontogenetic shifts in food preference reduces intraspecific competition as immature individuals eat different food types than adults. This diet plasticity could facilitate species' ability to successfully invade and establish itself in a new environment, even when co-occurring with phylogenetically close species. Here, ontogenetic diet shifts of a non-native piranha species (Serrasalmus marginatus) was tested by analyzing the relationship between its body length and the carbon and nitrogen stable isotope signatures. Carbon stable isotope was not correlated to fish length, but positive significant correlation between δ15N values and fish length was found for the non-native piranha. Also, immature and adult S. marginatus showed low isotopic niche overlap. The correlation between fish length and δ15N, and the low trophic overlap between immature and adult, indicate that the non-native S. marginatus had ontogenetic shifts in food preference, which may be viewed as an additional mechanism underlying its successful establishment in the upper Paraná River. Our findings indicate that ontogenetic shifts in food preference may be an invasive trait that facilitates the establishment of non-native fish species in tropical aquatic systems.


Assuntos
Caraciformes , Animais , Isótopos de Carbono , Dieta/veterinária , Ecossistema , Humanos , Isótopos de Nitrogênio , Rios
9.
Sci Total Environ ; 769: 144524, 2021 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-33482541

RESUMO

Non-native species are considered a major global threat to biodiversity, and their expansion to new ecosystems has recently increased. However, the effect of non-native species on ecosystem functioning is poorly understood, especially in hyperdiverse tropical ecosystems of which long-term studies are scarce. We analyzed the relationship between richness, biomass, and ß-diversity of non-native and native fishes during 16 years in five hyperdiverse tropical shallow lakes. We further elucidated how an observed increase in the proportion of richness, biomass, and ß-diversity of non-native over native fishes affect crucial multifunctional processes of lakes (decomposition, productivity). We found a general positive relationship between the richness and biomass of non-native and native fishes. However, the slope of this relationship decreased continuously with time, displaying an increase in non-native species richness and a decrease in native species richness over time. We also detected a negative relationship between the ß-diversity of non-native and native fishes over time. Moreover, the increase in the non-native:native ratio of species richness, biomass, and ß-diversity over time decreased ecosystem multifunctionality. Our results suggest that non-native fishes caused a homogenization of the native fish species over time, resulting in impoverishment of ecosystem multifunctionality; in part because non-native fishes are less productive than native ones. Therefore, focus on long-term effects and use of multiple biodiversity facets (α- and ß-diversity) are crucial to make reliable predictions of the effects of non-native fish species on native fishes and ecosystem functioning.


Assuntos
Ecossistema , Lagos , Animais , Biodiversidade , Biomassa , Peixes
10.
J Anim Ecol ; 89(11): 2427-2439, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32860423

RESUMO

Turbidity plays an important role in aquatic predator-prey interactions. Increases in turbidity are expected to reduce prey capture rates, especially for visually oriented predators. However, there is also evidence indicating that turbidity may have little or no effect on predation rates. Here, we conducted a systematic review and meta-analysis of the relationship between turbidity and capture rate. We explored possible sources of heterogeneity in the effect sizes (capture strategy, predator's body size, relative eye size and turbidity range in the experiments) while controlling for the dependence among effects sizes and phylogenetic relationships among predator species. We found a consistent negative effect of turbidity on prey capture and that turbidity range (manipulated in the experiments) was the main factor accounting for between-study variation in effect sizes. Also, capture rates of both visually and non-visually oriented predators decreased with an increase in turbidity. In addition, for visually oriented fish predators, the relative eye size did not influence the effect sizes. Despite the paucity of studies for some groups of aquatic predators (mainly in tropical regions), we provide corroborative evidence that turbidity is a critical environmental factor controlling predator-prey interactions. This result is especially relevant considering that changes in turbidity is a human-induced pervasive environmental alteration resulted from, among other mechanisms, runoff after deforestation, eutrophication or oligotrophication in reservoir cascades, which imply changes in predator-prey interactions.


Assuntos
Cadeia Alimentar , Comportamento Predatório , Animais , Tamanho Corporal , Peixes , Filogenia
11.
Case Rep Dent ; 2019: 1230610, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31511793

RESUMO

In cases where malocclusion is associated with intrinsic discoloration and/or discrepancies in tooth size and shape, such as peg-shaped laterals, orthodontics alone may not improve the aesthetics. In these situations, veneers may be considered as an adjunct to orthodontic treatment to improve the overall aesthetics. The aim of this study is to report a clinical case where an uneven occlusal plane was corrected, and the positioning of gingival zeniths, color, shape, and size of the dental elements involved were improved by means of gingivectomy and rehabilitation with 10 ceramic laminate veneers. It was possible to conclude that multidisciplinary treatment, when properly planned and indicated, respecting the limits and established techniques of periodontics, prosthesis, and dentistry, makes small occlusal leveling predictable and possible through these tools.

12.
Sci Total Environ ; 664: 215-221, 2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-30743114

RESUMO

Sugarcane is one of the main crops used around the world as a feedstock for the production of sucrose and biofuel. Prior to harvesting, sugarcane dry leaves are burned to facilitate manual cutting and enhance productivity. This practice generates ashes from sugarcane straw (hereafter referred as SCA), which may be carried to aquatic ecosystems, where its impacts on organisms and ecosystem integrity remain unknown. Here, we experimentally tested the toxicity of five different concentrations of SCA (0, 1000, 1500, 2000 and 2500 mg/L) on three native (Astyanax lacustris, Moenkhausia bonita and M. forestii) and two non-native (Oreochromis niloticus and Poecilia reticulata) fish from the Paraná River Basin, Brazil. The toxicity was estimated by calculating the median lethal concentration (LC50-24h) and the hepatosomatic index (HSI). We hypothesised that native fish are more sensitive to an increase in SCA than non-native fish. We verified that the mortality of native fish sharply increased with the increase in higher SCA concentration (LC50-24h values: A. lacustris = 2525.71 mg/L, M. bonita = 2124.95 mg/L and M. forestii = 1981.74 mg/L). However, no deaths were recorded for non-native fish species in any SCA concentrations. Accordingly, the HSI index values statistically differed with the increase in SCA concentrations for native fish, while for non-native fish we did not observe any difference. Therefore, only native species died or suffered liver damage with an increase in SCA concentrations. Extrapolating our findings to natural environments, we suggest that sugarcane burning, a widely used agricultural technique, has the potential to reduce the population size of native organisms and facilitate the dominance of non-native fish species in aquatic ecosystems.


Assuntos
Agricultura/métodos , Incêndios , Saccharum/crescimento & desenvolvimento , Poluentes Químicos da Água/análise , Animais , Brasil , Characidae , Ciclídeos , Ecossistema , Monitoramento Ambiental
13.
Braz. arch. biol. technol ; 62: e19180382, 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1039119

RESUMO

Abstract Low number of fetal cells in maternal blood limited the use of fetal materials in diagnostic and clinical applications. This research developed a technology which allowed the extraction of fetal DNA by a non-invasive method that offers no risk to the mother or fetus. A total of 132 pregnant women participated in this inquiry. The DNA extraction was performed employing an in-house method based on guanidine thiocyanate and magnetic bead. For the amplification it was used the Quantifier Y Kit™. The fetal sexing analysis of the 132 pregnant women were 100% in agreement with the ultrasound. Sensitivity and specificity for detection of Y chromosome sequences was possible using Real-Time Polymerase Chain Reaction since the 4th week of gestation. This non-invasive early determination could be employed in fetal gender and also to be extended to detection of genetic diseases in the shortest possible time avoiding invasive methods that puts the fetus at risk.


Assuntos
Análise para Determinação do Sexo/métodos , Reação em Cadeia da Polimerase em Tempo Real/instrumentação , Teste Pré-Natal não Invasivo/métodos
14.
Biota Neotrop. (Online, Ed. ingl.) ; 19(1): e20180574, 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-974030

RESUMO

Abstract: The Devonian Escarpment (DEEPA), located in the south of Brazil, represents an important area of environmental preservation composed by grasslands, gallery forests, as well as rock outcrops and archaeological sites. A law project (LP 527/2016), which suggests a reduction of the DEEPA area in approximately 70% of its original area (from 393,579 to 125,895 ha), is currently being processed in the Paraná State House of Representatives. Such reduction seems to be related to economic interests (mainly agriculture and mining) in the state of Paraná. If approved, LP 527/2016 will allow farmers to deliberately expand their activities, with the suppression of natural forest as main consequence. Additionally, loss of faunal diversity, contamination of water and soils, and alteration in nutrient cycles are expected, due the intensive use of agrochemicals. In addition to the direct environmental consequences, we expect the disappearance of areas of high geological interest, reducing local geodiversity, as well as substantial economic losses with ecotourism. Brazil is a signatory to the United Nations Convention on Biological Diversity, where it undertakes to develop strategies to prevent biodiversity loss and ecosystem degradation by 2020. An approval of the LP would be contradictory, considering that there are few natural vegetation areas in this region of the country. We emphasize that the proposal of such projects goes against the sustainability in the country and disregard the scientific knowledge generated until then. Thus, it is necessary to develop regional and federal political objectives that guarantee economic development in a balanced way, considering the local bio and geodiversity, not the proposal of mechanisms that destroy them.


Resumo: A Escarpa Devoniana (APAED), localizada no sul do Brasil, representa uma importante área de preservação ambiental composta por campos, matas de galeria, além de afloramentos rochosos e sítios arqueológicos. Atualmente, tramita na câmara dos deputados do estado do Paraná um projeto de lei estadual (PL 527/2016) que sugere a redução da área da APAED em aproximadamente 70% de sua área original (de 393.579 para 125.895 ha). Tal redução parece estar relacionada com interesses econômicos (principalmente agropecuária e mineração) no estado do Paraná. Caso aprovado, o PL 527/2016 permitirá que agricultores expandam suas atividades deliberadamente, tendo como consequência principal a supressão de áreas de floresta nativa. Com isso, espera-se perda de diversidade faunística, contaminação de água e solos e alteração nos ciclos de nutrientes, dado o aumento no uso de agroquímicos. Além das consequências ambientas diretas, podemos esperar o desaparecimento de elevado interesse geológico, reduzindo a geodiversidade local, além de substanciais perdas econômicas com ecoturismo. O Brasil é um dos países signatários da Convenção da Diversidade Biológica das Nações Unidas, onde se compromete a desenvolver estratégias que evitem a perda da biodiversidade e a degradação de ecossistemas até 2020. Assim, a aprovação desse projeto de lei é, no mínimo, contraditória considerando que existem poucas áreas de vegetação natural nessa região do país. Destacamos que a proposta de tais projetos vai contra a sustentabilidade no país e desconsideram o conhecimento científico gerado até então. Dessa forma, é necessário o desenvolvimento de objetivos políticos regionais e federais que garantam o desenvolvimento econômico de forma equilibrada, considerando a bio e geodiversidade local, e não a proposta de mecanismos que as destruam.

15.
Prótesenews ; 5(1): 18-30, jan.-mar. 2018. ilus
Artigo em Português | BBO - Odontologia | ID: biblio-906300

RESUMO

Os avanços na tecnologia dos materiais odontológicos têm permitido o desenvolvimento de técnicas mais conservadoras e aumentaram as chances de obter resultados estéticos mais previsíveis. Considerando as particularidades de cada técnica, a cerâmica tem sido usada devido à sua biocompatibilidade, longevidade e semelhança com a aparência natural do dente. O objetivo deste trabalho foi utilizar uma técnica minimamente invasiva previsível tanto esteticamente quanto funcionalmente para a confecção de dez laminados cerâmicos. Foi possível concluir que a proposta deste trabalho cumpriu com os requisitos para que uma reabilitação seja adequada nos quesitos de estética, função e estabilidade em longo prazo.


Technology advances in dental materials has allowed the development of more conservative techniques and increased the chances of more predictable aesthetics results. Considering the particularities of each technique, ceramics have been used due to its biocompatibility, longevity and likeness with the tooth natural appearance. The aim of this study was to use a predictable minimally invasive technique both aesthetically and functionally to fabricate 10 ceramic laminate veneers. It was concluded that the proposed technique in this work met the requirements for an esthetic, functional, and stable long-term rehabilitation.


Assuntos
Humanos , Feminino , Adulto , Cimentação , Porcelana Dentária , Planejamento de Prótese Dentária , Estética Dentária , Facetas Dentárias
16.
Diabetol Metab Syndr ; 9: 86, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29075334

RESUMO

BACKGROUND: Previous studies showed that metabolic syndrome is associated with aortic valve calcification (AVC) and poor outcomes in aortic stenosis (AS). However, if these associations change and how body fat impacts the prognosis of patients in late stage of the disease have been not yet explored. AIMS: To determine the association of body mass index (BMI) and visceral fat with AVC and mortality after transcatheter aortic valve replacement (TAVR). METHODS: This was a prospective cohort of 170 severe AS patients referred to TAVR. We quantified AVC mass score and fat depots including epicardial adipose tissue, intrathoracic fat, and abdominal visceral (VAF) and subcutaneous fats by computed tomography. Fat depots were indexed to body surface area. All-cause and cardiovascular-related deaths after TAVR were recorded over a median follow-up of 1.2 years. RESULTS: Higher AVC mass was independently associated with low BMI and low VAF. All-cause mortality risk increased with the decrease of BMI and increment of VAF. A stratified analysis by obesity showed that in non-obese, VAF was inversely associated with mortality, whereas in obese, high VAF was associated with higher mortality (p value for interaction < 0.05). At long-term, hazard ratio [HR] with non-obese/low VAF was 2.3 (95% confidence interval [CI] 1.1-4.9; p = 0.021) and HR with obese/high VAF was 2.5 (95% CI 1.1-5.8; p = 0.031) compared with obese/low VAF patients. CONCLUSIONS: In AS patients submitted to TAVR, BMI and VAF were inversely associated with AVC. Pre-intervention assessment of VAF by computed tomography may provide a better discrimination of mortality than BMI alone.

17.
Food Res Int ; 101: 198-202, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28941684

RESUMO

The influence of cooking on the nutritional value of king mackerel when cooked in coconut milk or pan fried in coconut oil was verified from the alterations in the fatty acid content; formation of cholesterol oxides and the nutritional quality indices of the lipids. Cooking in coconut milk caused an 11.6% reduction in the protein content and 28.3% reduction in the ash content. The lipid content increased after cooking (253%) and frying (198%) causing an increase in the caloric value. The total saturated and monounsaturated fatty acids of the cooked king mackerel increased 462% and 248%, respectively, whereas these increases were 418% and 130%, respectively, for the fried king mackerel. There were reductions of 21% and 38% in the total EPA+DHA of the pan fried and cooked samples, respectively, as compared to the fresh king mackerel. The heat treatment did not cause alterations in cholesterol content.


Assuntos
Óleo de Coco , Culinária/métodos , Peixes , Lipídeos/química , Alimentos Marinhos , Animais , Colesterol/análise , Cocos , Ácidos Graxos/análise , Temperatura Alta , Valor Nutritivo
19.
J Interv Cardiol ; 29(1): 117-23, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26728663

RESUMO

OBJECTIVE: This study sought to evaluate the impact of aortic valve (AV) and left ventricle outflow tract (LVOT) calcium on paravalvular regurgitation (PVR) and need for balloon post-dilatation (BPD) during transcatheter aortic valve implantation (TAVI). METHODS: The overall study population comprised 152 patients. Calcium mass and volume of AV and LVOT were estimated from contrast-enhanced multislice computed tomography imaging, using 3 thresholds for calcium detection [650, 850, and 1,050 Hounsfield units (HU)]. RESULTS: A self-expandable prosthesis was implanted in 67.8% of patients and a balloon-expandable prosthesis in the remaining. Eleven patients required BPD and 82 patients presented post-procedural PVR, which was mild in 44.1% and moderate in 9.9%. The greatest discriminatory value for PVR ≥ mild was seen for calcium volume using 850 HU threshold, with an area under the curve of 0.72 (95%CI 0.64-0.80, P < 0.001) for AV and of 0.63 (95%CI 0.54-0.72, P = 0.008) for LVOT. For 850 HU threshold, the calcium volume cut-off with the highest sum of sensitivity and specificity for PVR was 157 mm(3) for AV and 0.6 mm(3) for LVOT. In multivariate logistic regression analysis, the presence of AV calcium ≥157 mm(3) (OR 3.83, 95%CI 1.81-8.10, P < 0.001) and ≥267 mm(3) (OR 11.3, 95%CI 1.2-103.1, P = 0.03) were the only independent predictors of PVR and BPD, respectively. CONCLUSIONS: AV calcium volume was an independent predictor of PVR and BPD in patients submitted to TAVI. Our results support a systematic assessment of AV calcium volume to identify patients at increased risk of post-procedural PVR.


Assuntos
Insuficiência da Valva Aórtica , Estenose da Valva Aórtica/cirurgia , Valva Aórtica , Calcinose/diagnóstico , Complicações Pós-Operatórias , Substituição da Valva Aórtica Transcateter , Idoso , Idoso de 80 Anos ou mais , Valva Aórtica/patologia , Valva Aórtica/cirurgia , Insuficiência da Valva Aórtica/diagnóstico , Insuficiência da Valva Aórtica/etiologia , Cálcio/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores/métodos , Portugal , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Valor Preditivo dos Testes , Medição de Risco , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Substituição da Valva Aórtica Transcateter/efeitos adversos , Substituição da Valva Aórtica Transcateter/métodos , Resultado do Tratamento
20.
An Bras Dermatol ; 90(3 Suppl 1): 203-5, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26312717

RESUMO

Paracoccidioidomycosis is an infectious disease whose etiological agent belongs to the Paracoccidioides genus. Although it affects primarily the lungs, it can spread to other tissues, including the skin and mucous membranes. Despite the clinical treatment for this disease, scarring can produce sequelae, manifesting as anatomical and functional deformities of the face. We present a case of extensive, nasal unaesthetic and functional sequelae resulting from paracoccidioidomycosis, reconstructed using the paramedian forehead flap in three stages, through the regional unit principles.


Assuntos
Testa/cirurgia , Deformidades Adquiridas Nasais/cirurgia , Paracoccidioidomicose/cirurgia , Rinoplastia/métodos , Retalhos Cirúrgicos/cirurgia , Adulto , Humanos , Masculino , Transplante de Pele/métodos , Resultado do Tratamento
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