Dysphagia and pulmonary complications in acute cerebrovascular disease: A retrospective observational study / Disfagia y complicaciones pulmonares en la enfermedad cerebrovascular aguda: estudio observacional retrospectivo

Introduction: Dysphagia is a common post-stroke complication, which may result in serious pulmonary sequelae. Early detection of dysphagia and aspiration risk can reduce morbidity, mortality and length of hospitalization. Objectives: This study aims to identify association between dysphagia and acute cerebrovascular disease, and evaluate the prevalence and impact of pulmonary complications on readmissions and mortality. Material and methods: Retrospective observational study based on 250 clinical records of patients with acute cerebrovascular disease: clinical history, neurological examination, imaging and Gugging Swallowing Screen in the first 48h. Patients were followed for 3 months via medical records to estimate 3-month mortality and readmissions. Results: Out of 250 clinical records analyzed, 102 (40.8%) were evaluated for dysphagia. The prevalence of dysphagia was 32.4%. The risk was higher in older patients (p<0.001), in severe stroke (p<0.001) and in the hemorrhagic subtype (p=0.008). An association was found with dysarthria and aphasia (p=0.003; p=0.017). Respiratory tract infections occurred in 14.4% of all patients (GUSS group 11.8% versus no GUSS group 16.2%), and in 75% of those with severe dysphagia (p<0.001). Mortality at 3 months was 24.2% in dysphagic patients, especially high in the severe dysphagia group (75%, p<0.001). Conclusions: The type of cerebrovascular disease, NIHSS and GCS scores, age, dysarthria, and aphasia were significant associated factors to dysphagia. The prevalence of respiratory tract infections was higher in patients with no GUSS record, and no statistical significance was observed in related readmissions. Mortality at 3 months was superior in the severe dysphagia group.(AU)

Introducción: La disfagia es una complicación frecuente posterior a un evento cerebrovascular, que puede provocar graves secuelas pulmonares. La detección temprana de la disfagia y el riesgo de aspiración puede reducir la morbilidad, la mortalidad y la duración de la hospitalización. Objetivos: Este estudio pretende identificar asociaciones entre la disfagia y la enfermedad cerebrovascular aguda, y evaluar la prevalencia y el impacto de las complicaciones pulmonares en los reingresos y en la mortalidad. Material y método: Estudio observacional retrospectivo basado en 250 historias clínicas de pacientes con enfermedad cerebrovascular aguda: historia clínica, examen neurológico, pruebas de imagen y Gugging Swallowing Screen (GUSS) en las primeras 48h. Los pacientes fueron seguidos durante 3 meses a través de las historias clínicas para estimar la mortalidad a los 3 meses y los reingresos. Resultados: De las 250 historias clínicas analizadas, 102 (40,8%) fueron evaluados por disfagia. La prevalencia de disfagia fue del 32,4%. El riesgo fue mayor en los pacientes de mayor edad (p<0,001), en el ictus grave (p<0,001) y en el subtipo hemorrágico (p=0,008). Se encontró asociación con la disartria y la afasia (p=0,003; p=0,017). Las infecciones del tracto respiratorio se produjeron en el 14,4% de todos los pacientes (grupo GUSS 11,8% vs. grupo sin GUSS 16,2%), y en el 75% de los que tenían disfagia grave (p<0,001). La mortalidad a los 3 meses fue del 24,2% en pacientes disfágicos, especialmente alta en el grupo de disfagia grave (75%; p<0,001). Conclusiones: El tipo de enfermedad cerebrovascular, las puntuaciones NIHSS y GCS, edad, disartria y afasia fueron factores asociados de forma significativa a la disfagia. La prevalencia de infecciones del tracto respiratorio fue mayor en los pacientes sin registro GUSS, y no se observó significación estadística en los reingresos relacionados. La mortalidad a los 3 meses fue superior en el grupo de disfagia grave.(AU)

Dysphagia and pulmonary complications in acute cerebrovascular disease: A retrospective observational study.

INTRODUCTION: Dysphagia is a common post-stroke complication, which may result in serious pulmonary sequelae. Early detection of dysphagia and aspiration risk can reduce morbidity, mortality and length of hospitalization. OBJECTIVES: This study aims to identify association between dysphagia and acute cerebrovascular disease, and evaluate the prevalence and impact of pulmonary complications on readmissions and mortality. MATERIAL AND METHODS: Retrospective observational study based on 250 clinical records of patients with acute cerebrovascular disease: clinical history, neurological examination, imaging and Gugging Swallowing Screen in the first 48h. Patients were followed for 3 months via medical records to estimate 3-month mortality and readmissions. RESULTS: Out of 250 clinical records analyzed, 102 (40.8%) were evaluated for dysphagia. The prevalence of dysphagia was 32.4%. The risk was higher in older patients (p<0.001), in severe stroke (p<0.001) and in the hemorrhagic subtype (p=0.008). An association was found with dysarthria and aphasia (p=0.003; p=0.017). Respiratory tract infections occurred in 14.4% of all patients (GUSS group 11.8% versus no GUSS group 16.2%), and in 75% of those with severe dysphagia (p<0.001). Mortality at 3 months was 24.2% in dysphagic patients, especially high in the severe dysphagia group (75%, p<0.001). CONCLUSIONS: The type of cerebrovascular disease, NIHSS and GCS scores, age, dysarthria, and aphasia were significant associated factors to dysphagia. The prevalence of respiratory tract infections was higher in patients with no GUSS record, and no statistical significance was observed in related readmissions. Mortality at 3 months was superior in the severe dysphagia group.

Pollination of the strongly scented Sarcoglottis acaulis (Orchidaceae) by male orchid bees: nectar as resource instead of perfume.

The Neotropical orchid genus Sarcoglottis comprises ~40 species, which emit strong floral scents, presumably involved in pollinator attraction. Information on basic aspects of its natural history is scant, with the few studies available so far pointing to nectar-seeking orchid bees as pollinators. Here, we investigated the reproductive biology of Sarcoglottis acaulis, addressing the ecological meaning of its floral scent. In Atlantic Forest fragments of NE Brazil, we described the floral biology, determined the breeding system and recorded the pollinators of S. acaulis. Additionally, we chemically characterized its floral scent and assessed its role on pollinator attraction. Although self-compatible, S. acaulis depends on pollinators to boost fruit set. Male orchid bees of Eulaema atleticana and E. niveofasciata were the only recorded pollinators. They foraged for nectar only, in spite of the strong scent emitted by S. acaulis flowers. The floral scent is composed of six compounds, of which geraniol and nerol elicited electroantennographic responses in Eulaema bees. A synthetic mixture of these compounds attracted Eulaema bees in field assays but did not trigger the stereotyped scent-gathering behaviour. The floral scent of S. acaulis acts in signalling and nectar is the sole reward for pollinators. Despite the low pollinator frequency, S. acaulis shows a high fruit set (77%), particularly when compared to other orchids. Attributes such as pollinia that release small pollen loads, allowing a single pollinia-carrying bee to pollinate several flowers, low amount of nectar, steady-state flowering and traplining behaviour of pollinators, might act together to assure this outstanding fruit set.

Data for the Determination of Total Carbon in Biosolids using MID-Infrared Spectroscopy.

The data presented in this article relates to "Determination of Total Carbon in Biosolids using MID-Infrared Spectroscopy" published in Science of the Total Environment. In this new article, we present the data used for the development of the methodology using Partial Least Squares (PLS) combined with MID-Infrared (MID-IR) spectroscopy for the determination of total carbon in biosolids. Based on the data used, MID-IR combined with PLS was found to be an acceptable alternative and inexpensive method to determine the total C of biosolids compared to conventional methods such as the Dumas combustion method using a LECO C analyser.

Determination of total carbon in biosolids using MID-infrared spectroscopy.

This study was designed to determine if MID-Infrared (MID-IR) spectroscopy combined with Partial Least Squares (PLS) modelling could be used to predict total carbon (C) in biosolids generated from wastewater treatment plants. Biosolids samples were selected and analysed for total C, and MID-IR spectra were recorded. Using the total C and MID-IR data, a PLS model was developed using both the full spectral range and selected wavelengths regions. The PLS modelling showed that an R2 of 0.97 was achieved for both approaches. To validate the modelling, PLS prediction was applied to a randomly selected validation set of 20 samples and prediction uncertainties determined using The Unscrambler software. A prediction error (or uncertainty) of approximately ±2% carbon was achieved using both full spectra and selected wavelengths regions. Based on the results of the study, MID-IR combined with PLS could be used as an alternate and inexpensive method to determine the total C of biosolids compared to conventional methods such as the Dumas combustion method using a LECO C analyser.

In vitro evaluation of the antimicrobial effects of different intracanal medications in necrotic immature teeth.

AIM: This was to assess the antimicrobial effectiveness of pastes used as intracanal medicaments against Enterococcus faecalis in necrotic immature teeth. METHOD: An agar-disc diffusion method over a period of 30 days was used. The following medications were analysed: triple antibiotic paste (TAP) I; double antibiotic paste (DAP) I; DAP I with calcium hydroxide; calcium hydroxide paste with saline solution 0.9 %; calcium hydroxide paste with chlorhexidine 2 % gel; DAP II; DAP II with zinc oxide; DAP II with calcium hydroxide; and saline solution 0.9 % as control. The diameters of the halos of inhibition (in mm) of tested medicaments were determined and analysed with one-way analysis of variance and Tukey's post hoc tests. RESULTS: TAP I (G1) was significantly more effective against E. faecalis, and showed the largest halo of inhibition during all the experiments. DAP groups (G2 and G6) also showed inhibiting bacterial growth with said inhibition remaining stable throughout the 30-day period. In contrast, G4 and G5 groups, in which Ca(OH)2 was added to saline and chlorhexidine, had no antibacterial effect. CONCLUSIONS: TAP and DAP showed better antibacterial efficacy and remained active for 30 days. Combination of Ca(OH)2 with antibiotics should be avoided, due to the possibility of antibiotic hydrolysis.

Hematological markers and biochemical profiles in terms of gender and age of captive collared peccaries (Tayassu tajacu) in eastern Amazon.

Complete blood counts and blood biochemical analyses are laboratory tests that allow the monitoring of physiological condition, nutrition, and health in free-living or captive wild animals. When interpreting these tests, it is essential to compare the results with reference ranges that are suitable for the species. Few studies have been conducted on the hematological and biochemical characteristics of Tayassu tajacu, particularly for animals raised in the Amazon biome. The objectives of this study were to evaluate the influence of age and gender on the hematological and biochemical profiles of captive T. tajacu, and to establish reference intervals for these parameters. Complete blood counts and biochemical analyses were performed using manual methods and semi-automatic equipment, respectively. There were significant differences in relation to age in hematocrit and hemoglobin levels, and mean cell volumes, in captive T. tajacu. No basophils were observed, and the neutrophil:lymphocyte ratio was less than 1. Levels of total protein, urea, phosphorus, and alkaline phosphatase were significantly affected by age (P < 0.05). Gender did not affect any of the results. The hematological and biochemical parameters for this species were determined, and may be used as reference ranges for captive T. tajacu.

Biological restorations as an alternative to reconstructing posterior teeth: a case report.

This article reports on a three-year follow-up of two biological restorations performed on a 15-year-old female patient. After clinical evaluation, tooth fragments from extracted permanent molars were obtained from a Human Teeth Bank and were autoclaved, adjusted to the prepared cavity, and bonded to the remaining tooth structure with dual resin cement. The technical aspects are described and the benefits and disadvantages of biological restorations as an alternative treatment for rehabilitation of severely destroyed permanent molars are discussed.

Growth curve of female collared peccaries (Pecari tajacu) raised in captivity in the Brazilian Amazon Region / Curva de crescimento de fêmeas cateto (Pecari tajacu) criados em cativeiro na Amazônia Brasileira

This work aims to determine the most suitable nonlinear model to describe the growth of female collared peccaries (Pecari tajacu). The monthly records of the weight of 10 captive female collared peccaries over a period of two years in the Brazilian Amazon Region were used. The growth models used were the Von Bertalanffy, Brody, Gompertz and Logistic. The parameters were estimated by using the NLIN procedure from the SAS application. The criteria used to verify the adjustment of the models were: asymptotic standard deviation (ASD); coefficient of determination (R²); average absolute residual deviation (ARD) and the asymptotic rate (AR). The Brody model and the Logistic model estimated the highest (19.44kg) and the lowest (19.18kg) asymptotic weight (A), indicating the lowest (0.0070kg/day) and the highest (0.0121kg/day) maturation rate (K). These results and the coefficients of phenotypic correlation that varied from -0.75 and -0.47 confirmed the antagonistic nature between these parameters. The Brody model estimated the lower value for ARD, a limiting factor for describing the lowest value for AR through this model. The Brody model showed the best adjustment for AR, although the other models also showed a suitable adjustment to the weight data of said species/gender. Based on the AR obtained in this work, the Brody model is recommended for adjusting the growth curve of the female collared peccaries. Depending on the estimated values, especially for K, this trait can be included in a selection index.

Com o objetivo de ajustar modelos não-lineares, foram utilizados registros mensais do peso de 10 fêmeas de cateto (Pecari tajacu) coletados durante dois anos, no criatório do campo experimental Álvaro Adolfo da Embrapa Amazônia Oriental, Belém, PA. Utilizaram-se os modelos de Von Bertalanffy, Brody, Gompertz e Logístico. Os parâmetros foram estimados usando o procedimento NLIN do aplicativo SAS. Os critérios utilizados para verificar o ajuste dos modelos foram: desvio padrão assintótico (ASD); coeficiente de determinação (R²); desvio médio absoluto dos resíduos (ARD) e o índice assintótico (AR). Os modelos Brody e Logístico estimaram, respectivamente, o maior (19,44kg) e o menor (19,18kg) peso assintótico (A), caracterizando a menor (0,0064kg/dia) e a maior (0,0113kg/dia) taxa de maturação (K), haja vista a natureza antagônica entre estes parâmetros, comprovada pela correlação fenotípica variando entre -0,75 à -0,47. O modelo Brody estimou o menor valor para o ARD, fator limitante para caracterizar o menor valor para o AR por este modelo. Considerando o AR, o modelo Brody apresentou o melhor ajuste, contudo, pelos valores encontrados, os demais modelos também apresentaram ajuste adequando aos dados ponderais da referida espécie/sexo. Com base no AR adotado neste trabalho, recomenda-se o modelo Brody para ajustar a curva de crescimento de fêmeas de cateto (Pecari tajacu). Em razão dos valores estimados, sobretudo, para a K, essa característica pode ser incluída em um índice de seleção. Contudo, estudos com grupos mais representativos e criados em outras condições se faz oportuno.

Propriedades da carne e perfil de ácidos graxos do pernil de catetos (Tayassu tajacu) alimentados com torta de babaçu (Orbignya phalerata) / Meat properties and fatty acids profile of the ham of peccaries (Tayassu tajacu) fed babassu (Orbignya phalerata) meal

Analisaram-se as propriedades da carne e o perfil de ácidos graxos do pernil de catetos alimentados com dietas contendo diferentes porcentagens de torta de babaçu, usada como fonte energética alternativa substituindo parte do milho na alimentação, em sistemas de produção em cativeiro. Avaliou-se o pernil de 12 animais quanto às suas propriedades - perda de peso ao cozimento, força de cisalhamento, pH e capacidade de retenção de água-, depois extraiu-se o óleo da carne e determinou-se o perfil dos ácidos graxos. Não foram observados efeitos (P>0,05) das porcentagens de torta de babaçu sobre as propriedades da carne; os ácidos graxos (AG) insaturados, mono e poli-insaturados, foram encontrados em maior quantidade (51,6-57,8 por cento) que os ácidos graxos saturados (42,2-48,4 por cento) na carne do pernil. Baseando-se na teoria de que os AG poli-insaturados ingeridos na dieta humana são responsáveis pela redução nos níveis séricos de colesterol, sugere-se que a carne de catetos seja uma boa fonte alternativa de proteína.

The meat properties and the fatty acids profile of the ham of peccaries ham fed diets with different levels of babassu meal, used as an alternative energy source substituting part of corn on feeding peccaries in captivity, were studied. The ham meats of 12 animals were evaluated on their properties: cooking losses, shear force, pH, and water holding capacity. After that, the meat oil was extracted to determine the fatty acids contents. No effects (P>0.05) of the babassu meal levels on the meat properties were observed. The unsaturated fatty acids, mono and polyunsaturated, were found in higher quantity than the saturated fatty acids in the ham meat of peccaries. Based on the theory that the polyunsaturated fatty acids ingested in the human diet are responsible for reduction of the seric levels of cholesterol, it can be suggested that the peccary meat is a good alternative source of protein.

Protein kinase C: modulation of vasopressin-induced calcium influx and release in A7r5 vascular smooth muscle cells.

This study was guided by the hypothesis that specific isoforms of protein kinase C may participate in modulating increases in intracellular Ca2+ that are induced by stimulation of vascular smooth muscle cells with vasopressin. Immunoblot analysis revealed that A7r5 vascular smooth muscle cells expressed conventional (alpha), novel (delta and epsilon), and atypical (iota/lambda and mu) isoforms of protein kinase C. Stimulation of fura-2-loaded cells with 20 nM vasopressin induced a rapid transient increase in the intracellular concentration of calcium that was followed by a slowly declining component which was above baseline throughout the period of observation. Cell fractionation studies showed that the calcium response was associated with (a) transient translocation of the alpha and delta isoforms of protein kinase C from the cytosolic fraction to the particulate-membrane fraction, (b) sustained translocation of the epsilon isoform, and (c) no translocation of iota/lambda or mu isoforms. Ratiometric and isobestic fluorescence analysis showed that vasopressin-induced Ca2+ influx and release were markedly inhibited in cells that were preincubated with either 1 microM phorbol 12-myristate 13-acetate, or 10 microM 1, 2 dioctanoyl-sn-glycerol, two structurally different activators of protein kinase C. In contrast, vasopressin-induced increases in intracellular Ca2+ were not significantly altered following preincubation with either 1 microM 4alpha-phorbol or 4alpha-phorbol 12,13-didecanoate, analogs of phorbol 12-myristate 13-acetate that do not activate protein kinase C. Moreover, the inhibitory effects of phorbol 12-myristate 13-acetate were prevented by treatment with 1 microM GF109203X, a potent inhibitor of protein kinase C. Taken together, these results show that direct activation of protein kinase C can negatively modulate vasopressin-induced Ca2+ influx and release in cultured vascular smooth muscle cells. They also show that stimulation with vasopressin induces translocation of specific isoforms of protein kinase C, an observation suggesting that one or more of these isoforms may participate in modulation of vasopressin-induced increases in intracellular Ca2+.

Sindrome sincopal: enfoque actual. / Syncopal syndrome: present view

Se define el sincope como la perdida brusca y transitoria de conciencia a consecuencia del deterioro del metabolismo cerebral por reduccion del aporte de oxigeno y glucosa. Los sincopes se deben a caida de la presion de perfusion; a disminucion del debito cardiaco; a alteraciones metabolicas o a causas neurologicas. En la revision se analizan los mecanismos fisiopatologicos, las caracteristicas clinicas y el tratamiento de los sincopes que se presentan en la hipotension postural; en los reflejos vago-vagales; en la hipersensibilidad del seno carotideo; en las taquicardias y en las bradicardias, asociadas a enfermedad del nodulo sinusal y bloqueo auriculo-ventriculares. Se comentan la utilidad y las indicaciones de la electrocardiografia Holter o monitoria dinamica, asi como de la electrofisiologia y de la estimulacion electrica programada