Chronic Obstructive Pulmonary Disease: The Role of Myocardial Deformation Indices and Right Ventricle Three-Dimensional Echocardiography

Abstract Background: Right ventricular dysfunction is a major complication in chronic obstructive pulmonary disease (COPD) and, despite its prognostic implications, is rarely considered in routine clinical analysis. Objectives: To compare RV function variables with standard and advanced echocardiographic techniques in patients with stable COPD and controls. Methods: Twenty COPD patients classified as GOLD ≥ II (13 men aged 68.4 ± 8.3 years) and 20 matched controls were compared. Myocardial strain/strain rate indices were obtained by tissue Doppler and two-dimensional speckle tracking echocardiography. Right ventricular ejection fraction was obtained with three-dimensional software. Free wall myocardial thickness (FWMT) and tricuspid annular systolic excursion (TAPSE) were also measured. Numerical variables were compared between groups with Student's t-test or the Mann-Whitney test. Associations between categorical variables were determined with Fisher's exact test. P-values < 0.05 were considered statistically significant. Results: All myocardial deformation indices, particularly global longitudinal strain (-17.2 ± 4.4 vs -21.2: ± 4.4 = 0.001) and 3D right ventricular ejection fraction (40.8 ± 9.3% vs 51.1 ± 6.4% p <0.001) were reduced in COPD patients. These patients presented higher right ventricular FWMT and lower TAPSE values than controls. Conclusion: Myocardial deformation indices, either tissue Doppler or speckle tracking echocardiography and 3D right ventricular ejection fraction, are robust markers of right ventricular dysfunction in patients with stable COPD. Assessing global longitudinal strain by speckle tracking echocardiography is a more practical and reproducible method.

NaOCl effect on biofilm produced by Staphylococcus aureus isolated from the milking environment and mastitis infected cows / Efeito do hipoclorito de sódio em biofilmes produzidos por Staphylococcus aureus isolados do ambiente de ordenha e de vacas com mastite

Biofilms constitute a physical barrier, protecting the encased bacteria from detergents and sanitizers. The objective of this work was to analyze the effectiveness of sodium hypochlorite (NaOCl) against strains of Staphylococcus aureus isolated from raw milk of cows with subclinical mastitis and Staphylococcus aureus isolated from the milking environment (blowers and milk conducting tubes). The results revealed that, in the presence of NaOCl (150ppm), the number of adhered cells of the twelve S. aureus strains was significantly reduced. When the same strains were evaluated in biofilm condition, different results were obtained. It was found that, after a contact period of five minutes with NaOCl (150ppm), four strains (two strains from milk , one from the blowers and one from a conductive rubber) were still able to grow. Although with the increasing contact time between the bacteria and the NaOCl (150ppm), no growth was detected for any of the strains. Concerning the efficiency of NaOCl on total biofilm biomass formation by each S. aureus strain, a decrease was observed when these strains were in contact with 150 ppm NaOCl for a total period of 10 minutes. This study highlights the importance of a correct sanitation protocol of all the milk processing units which can indeed significantly reduce the presence of microorganisms, leading to a decrease of cow´s mastitis and milk contamination.

Biofilmes são constituídos de bactérias aderidas a uma superfície e aderidas entre si envolvidas por um polissacarídeo de constituição proteica, lipídica e glicídica que conferem uma barreira física às bactérias dentro deste microambiente. O objetivo deste trabalho foi analisar a eficácia do hipoclorito de sódio (NaOCl) contra estirpes de Staphylococcus aureus isoladas de leite cru de vacas com mastite subclínica e Staphylococcus aureus isolados do ambiente de ordenha (borrachas de ordenhadeiras e mangueiras condutoras de leite). Os resultados revelaram que, na presença de hipoclorito de sódio (150ppm), o número de células aderidas das 12 estirpes de S. aureus analisadas foi significativamente reduzido. Quando as mesmas estirpes foram avaliadas em condições de biofilme, diferentes resultados foram obtidos. Verificou-se que, após um período de contato de cinco minutos com NaOCl (150ppm), quatro estirpes (duas estirpes de leite, uma estirpe das borrachas das ordenhadeiras e uma estirpe de uma mangueira condutora de leite) ainda eram capazes de crescer. Com o aumento do tempo de contato do hipoclorito e as bactérias, cada vez maior, na concentração de 150ppm, não foi detectado o crescimento das estirpes. Em relação à eficácia do NaOCl na formação total da biomassa do biofilme por cada uma das estirpes de S. aureus, observou-se decréscimo da biomassa dos biofilmes quando estas estirpes estavam em contato com o NaOCl na concentração de 150ppm durante um tempo total de 10 minutos. O estudo demonstra a importância de um protocolo de saneamento correto de todas as unidades de processamento de leite, que pode, efetivamente, reduzir a presença de microrganismos de forma significativa, conduzindo a uma diminuição da mastite e da contaminação do leite.