Ingestion of a moderate dose of alcohol enhances physical exercise-induced changes in blood lactate concentration

The consumption of alcoholic beverages influences carbohydrate and lipid metabolism, although it is not yet clear whether metabolism during physical exercise at different intensities is also affected. This was the objective of the present study. Eight young and healthy volunteers performed a treadmill test to identify the running speed corresponding to a lactate concentration of 4 mM (S4mM). At least 48 h later, they were subjected to two experimental trials (non-alcohol or alcohol) in which they performed two 1-km running sessions at the following intensities: 1) S4mM; 2) 15% above S4mM. In both trials, blood lactate, triglycerides, and glucose concentrations were measured before and after exercise. The acute alcohol intake increased triglycerides, but not lactate concentration under resting conditions. Interestingly, alcohol intake enhanced the exercise-induced increase in lactate concentration at the two intensities: S4mM (non-alcohol: 4.2±0.3 mM vs alcohol: 4.8±0.9 mM; P=0.003) and 15% above S4mM trial (P=0.004). When volunteers ingested alcohol, triglycerides concentration remained increased after treadmill running (e.g., at S4mM - at rest; non-alcohol: 0.2±0.5 mM vs alcohol: 1.3±1.3 mM; P=0.048). In contrast, glucose concentration was not modified by either alcohol intake, exercise, or their combination. We concluded that an acute alcohol intake changed lactate and lipid metabolism without affecting blood glucose concentration. In addition, the increase in lactate concentration caused by alcohol was specifically observed when individuals exercised, whereas augmented triglycerides concentration was already observed before exercise and was sustained thereafter.

Síndrome da fragilidade no idoso comunitário com osteoartrite / Frailty syndrome in the community-dwelling elderly with osteoarthritis

OBJETIVO: Caracterizar e comparar idosos comunitários com osteoartrite (OA) de joelhos e/ou quadris, com enfoque na síndrome da fragilidade. MéTODO: Estudo transversal com avaliação de características sociodemográficas, comorbidades, medicamentos, depressão, antropometria, quedas, dor, rigidez, função, fragilidade e avaliação subjetiva da saúde em idosos com OA de joelhos e/ou quadris a partir de subamostra do estudo sobre fragilidade em idosos brasileiros (FIBRA). RESULTADOS: A amostra final foi composta de 58 idosos (74 ± 5,50 anos), como segue: 17 (29,31%) não frágeis, 28 (48,28%) pré-frágeis e 13 (22,41%) frágeis. O número de medicamentos foi maior no grupo frágil em comparação ao não frágil (7,00 ± 2,00 e 4,00 ± 2,00, respectivamente; P = 0,001). O Índice de Massa Corporal foi menor nos idosos não frágeis em comparação aos pré-frágeis e frágeis (média de 27,00 ± 4,50 kg/m², 30,00 ± 4,00 kg/m² e 34,00 ± 8,00 kg/m², respectivamente; P = 0,018). Depressão foi mais prevalente no grupo frágil. Em relação à saúde comparada ao ano anterior, houve diferença: 64,3% dos pré-frágeis e 46,2% dos frágeis acreditavam que sua saúde piorou; entre os não frágeis, 52,9% consideraram que a saúde permaneceu igual (P = 0,016). Quanto ao nível de atividade em relação ao ano anterior, pré-frágeis e frágeis relataram que houve piora (P = 0,010). Quanto à função e à autoeficácia para quedas, os frágeis mostraram-se piores que os demais (P = 0,023 e 0,017, respectivamente). Os outros itens avaliados não apresentaram diferenças significativas entre os grupos. CONCLUSÃO: Idosos com OA e fragilidade usam maior número de medicamentos, são mais obesos e mais deprimidos, têm pior percepção da saúde e do nível de atividade em relação ao ano anterior e pior autoeficácia para quedas e para função física.

OBJECTIVE: To characterize and compare community-dwelling elderly with knee and/or hip osteoarthritis (OA), focusing on the frailty syndrome. METHOD: Cross-sectional study of the elderly with knee and/or hip OA, using a subsample from the study of frailty in the Brazilian elderly (FIBRA), assessing the following: sociodemographic characteristics, comorbidity, medications, depression, anthropomorphic data, falls, pain, stiffness, physical function, and frailty. The subjective assessment of health was also performed. RESULTS: The final sample comprised 58 elderly (mean age, 74 ± 5.5 years) as follows: 17 (29.31%) non-frail, 28 (48.28%) pre-frail, and 13 (22.41%) frail. The frail elderly received more medications than the non-frail ones (7.00 ± 2.00 and 4.00 ± 2.00, respectively; P = 0.001). The mean Body Mass Index was lower in the non-frail elderly as compared with those of the pre-frail and frail ones (27.00 ± 4.50 kg/m², 30.00 ± 4.00 kg/m², and 34.00 ± 8.00 kg/m², respectively; P = 0.018). Depression was more prevalent in the frail group. Compared to the previous year, there was a difference in the health status of the groups as follows: 64.3% of the pre-frail elderly and 46.2% of the frail ones believed their health deteriorated, and 52.9% of the non-frail elderly considered that their health status remained unchanged (P = 0.016). When comparing the current physical activity levels with those of the previous year, the pre-frail and frail elderly reported a worsening (P = 0.010). Regarding physical function and fall-related self-efficacy, the frail elderly were worse than the others (P = 0.023 and 0.017, respectively). There were no significant differences between the groups for the remaining items analyzed. CONCLUSION: The elderly with OA and frailty use more medications, are more obese and depressed, have a poorer perception of their own health and of their level of activity as compared with that of the previous year, have a worse fall-related self-efficacy, and worse physical function.

Análise comparativa do estado nutricional de pré-escolares / Comparative analysis of nutritional status of preschool children

OBJETIVO: Comparar a avaliação do estado nutricional de pré-escolares segundo referência nacional de Conde e Monteiro (2006) e internacional do Centers for Disease Control (CDC, 2000) e da Organização Mundial da Saúde (OMS, 2006). MÉTODOS: Estudo transversal, com 312 pré-escolares frequentadores de creches no estado do Rio de Janeiro. A avaliação do estado nutricional baseou-se na antropometria, seguindo técnica padronizada. De acordo com os critérios do CDC e da OMS, o diagnóstico do estado nutricional baseou-se nos índices peso/idade, peso/estatura e estatura/idade, considerando-se com baixo peso, sobrepeso e obesidade crianças abaixo de percentil 15, maior ou igual ao percentil 85 e maior ou igual ao percentil 97, respectivamente. O diagnóstico do estado nutricional, segundo os critérios de Conde e Monteiro, utilizou o IMC, com pontos de corte estabelecidos pelos autores. Na análise estatística, aplicaram-se os testes de Friedmam e qui-quadrado, sendo significante p<0,05. RESULTADOS: Nos pré-escolares de ambos os sexos, verificou-se não haver diferenças significativas quando comparados os critérios de IMC (peso/estatura²) ao índice peso/estatura pelos critérios do CDC e OMS. Em relação ao índice peso/idade, não foi observada diferença entre meninas e meninos na classificação obtida pelo CDC e pela OMS. Entretanto, foi observada diferença no grupo dos meninos quanto aos critérios de classificação do CDC e da OMS para o índice estatura/idade (qui-quadrado; p=0,0026). CONCLUSÕES: Foi possível inferir que os critérios utilizados para avaliação antropométrica de pré-escolares não diferem expressivamente entre si, exceto para o índice estatura/idade em meninos.

OBJECTIVE: To compare the nutritional assessment of preschool children according to Brazilian (Conde and Monteiro, 2006) and international guidelines (Centers for Disease Control - CDC, 2000, and World Health Organization - OMS, 2006). METHODS: Cross-sectional study with 312 preschool children attending day care centers in Rio de Janeiro State, Brazil. Assessment of nutritional status was based on anthropometry done by the standard technique. The diagnosis of nutritional status according to CDC and WHO was based on the weight-for-age, weight-for-height and height-for-age indexes, considering underweight, overweight and obesity measures <15th percentile, >85th percentile and >97th percentile, respectively. The classification of nutritional status based on the Body Mass Index (BMI) used the cut-off points established by Conde and Monteiro. The statistical analysis used Friedmam and chi-square tests, being significant p<0.05. RESULTS: No differences were noted between preschool genders when comparing the BMI criteria and the weight/height index of CDC and WHO criteria. Regarding the weight/age index, no differences were observed for both girls and boys with the CDC and WHO criteria. However, there were differences when these criteria were compared for height/age index for boys (chi-square, p=0.0026). CONCLUSIONS: Criteria used for the nutritional assessment of preschool children do not differ significantly among themselves, except for the height/age index for boys.

Avaliação do estado nutricional de escolares segundo três referências / Nutritional status evaluation in schoolchildren according to three references

OBJETIVO: Comparar a avaliação do estado nutricional de escolares de acordo com as três curvas de referências. MÉTODOS: AS variáveis peso e estatura de 181 crianças na faixa etária de cinco a dez anos foram obtidas de um banco de dados de vigilância nutricional de escolares da Ilha de Paquetá, organizado de acordo com as recomendações do Sistema de Vigilância Alimentar e Nutricional (Sisvan). O gráfico de Bland Altman e a razão de desvios foram empregados para construir perfis de concordância entre as três curvas de referência de avaliação nutricional dois a dois, utilizando-se os valores do índice de massa corporal. Na determinação da prevalência de déficit pôdero-estatural e sobrepeso, utilizaram-se os pontos de cortes recomendados por Cole, pelo Centers for Diseases Control and Prevention e por Conde e Monteiro. RESULTADOS: A prevalência de obesidade em meninas foi igual (3,1 por cento) para Cole e Conde e Monteiro e ambas se sobrepuseram à obtida por meio da curva do Centers for Diseases Control and Prevention de 2000 (2,0 por cento). Em relação aos meninos, a prevalência de obesidade obtida por Conde e Monteiro (4,8 por cento) foi menor do que os percentuais encontrados por Cole (7,2 por cento) e pelo CDC (7,2 por cento). CONCLUSÕES: Os resultados sugerem que a escolha do referencial brasileiro (Conde e Monteiro) não dificulta a comparação com outros critérios internacionais, principalmente no que tange à classificação de obesidade em escolares do gênero masculino.

OBJECTIVE: To compare the nutritional status of schoolchildren according to three different reference curves. METHODS: The weight and height of 181 children aged 5-10 years were obtained from a database for the nutritional surveillance of schoolchildren from Paquetá Island, RJ, Brazil, which had been designed in compliance with recommendations of the Brazilian Food and Nutrition Surveillance System (Sistema de Vigilância Alimentar e Nutricional, Sisvan). Bland-Altman plot and deviation ratios were used to produce profiles of agreement between pairs of nutritional assessment references using body mass index values. Cutoff values of the following standards were used in order to determine the prevalence of overweight and weight and height deficit: Cole, Centers for Disease Control and Prevention (CDC), and Conde & Monteiro. RESULTS: The prevalence rates for obesity in girls were similar using the Cole and Conde & Monteiro (3.1 percent) cutoffs, but the prevalence rate according to the CDC standard was significantly lower (2.0 percent). For boys, the prevalence of obesity using the Conde & Monteiro cutoff (4.8 percent) was lower than the rates obtained using the cutoffs suggested by Cole (7.2 percent) and by the CDC (7.2 percent). CONCLUSIONS: These results suggest that the choice of the Brazilian reference curve (Conde & Monteiro) does not impair the comparison with other international standards, particularly for obesity in male schoolchildren.

Seguridad y eficacia de la biopsia renal percutánea / Safety and efficacy of percutaneous renal biopsy

Se realizó una evaluación de la seguridad y eficacia del procedimiento de la biopsia renal percutánea BRP de riñones nativos bajo control ecográfico simultáneo. Se revisaron las historias clínicas de todos los pacientes que fueron biopsiados en el período comprendido entre enero de 2005 y diciembre de 2008 en el Servicio de Nefrología del Hospital de Pediatría Juan P. Garrahan. Se excluyeron del análisis los procedimientos realizados bajo anestesia general y en riñón transplantado. Se evaluaron 117 procedimientos realizados en 114 pacientes: 59 varones (50.4%) y 55 mujeres (49.6%). Las indicaciones más frecuentes de BRP fueron: proteinuria masiva o significativa con o sin hematuria 45 (38,6%), Lupus Eritematoso Sistémico 32 (27.4%) y síndrome nefrótico cortico-resistente 23 (20%); otras menos frecuentes estuvieron representadas por: Púrpura de Schönlein-Henoch 7 (6%), insuficiencia renal aguda (IRA) 5 (4%) e insuficiencia renal crónica (IRC) 5 (4%). No se produjeron eventos adversos (EA) en 97 (83%) procedimientos. En 20 (17%), se produjeron EA. Los EA no serios fueron 9: microhematuria (n=3), macrohematuria (n=3) y dolor lumbar (n=3). Los 11 restantes fueron EAS (serios) que correspondieron a hematomas perirrenales de los cuales 2 requirieron transfusión de glóbulos rojos. Las muestras obtenidas fueron suficientes para el diagnóstico en 113 procedimientos (97%), con un número de glomérulos de 30 ± 11. Los resultados demostraron que el procedimiento de BRP con disparador automático, anestesia local y control ecográfico simultáneo es seguro y eficaz. El número de EAS registrados en este estudio es similar o menor según las series analizadas. A diferencia de la publicación internacional en nuestro centro se realiza el procedimiento con el paciente despierto (AU)

In this study we evaluated the safety and efficacy of ultrasound-guided percutaneous renal biopsy (PRB) of native kidneys. The clinical charts of all patients that underwent PRB between January 2005 and December 2008 at the Department of Nephrology of the Pediatric Hospital Juan P. Garrahan were reviewed. Procedures performed under general anesthesia and in transplanted kidneys were excluded from the analysis. We evaluated 117 procedures performed in 114 patients: 59 were male (50.4%) and 55 female (49.6%). The most frequent indications for PRB were: massive or significant proteinuria with or without hematuria 45 (38,6%), systemic lupus erythematosus 32 (27.4%), and steroid-resistant nephrotic syndrome 23 (20%); other less frequent indications were: Henoch-Schönlein purpura 7 (6%), acute renal insufficiency (ARI) 5 (4%), and chronic renal insufficiency (CRI) 5 (4%). No adverse events (AE) were observed in 97 (83%) procedures. AE were seen in 20 (17%). There were 9 minor AE: microhematuria (n=3), gross hematuria (n=3), and lumbar pain (n=3). Serious AE observed were perinephric hematoma in 11 patients of whom 2 required red blood cell transfusions. The sample size was sufficient for diagnosis in 113 procedures (97%), with a number of glomeruli of 30 ± 11. The results show that ultrasoundguided PRB with an automatic trigger and local anesthesia is a safe and effective procedure. The number of serious AE in this study is similar to or lower than reported in previous series. Unlike other international series, at our center the procedure is performed while the patient is awake (AU)

Suscetibilidade à azitromicina de isolados bacterianos de processos infecciosos em cães e gatos / Susceptibility to azithromycin of bacteria isolated from infectious processes in dogs and cats

O presente estudo avaliou o perfil de suscetibilidade à azitromicina de patógenos bacterianos prevalentes em diferentes sítios infecciosos de animais de companhia. Adicionalmente, foram estudados o perfil de atividade in vitro de azitromicina contra esses patógenos e sua concentração inibitória mínima (CIM). Testes como a difusão em disco e a microdiluição em caldo detectaram resistência respectivamente em 48,6 por cento e 55 por cento dos isolados de Staphylococcus spp. e em 55,3 por cento e 72,7 por cento dos bastonetes Gram-negativos. A CIM50 para S. aureus foi 4,0mg/mL, para S. intermedius foi de 1,0mg/mL, para Staphylococcus spp. coagulase-negativas foi de e"512mg/mL e para bastonetes Gram-negativos foi de 256mg/mL. Quinze por cento (9/60) dos isolados oxacilina-resistente e multidroga-resistentes, mecA-positivos, de Staphylococcus spp. apresentaram também resistência à azitromicina. A disseminação de bactérias multidroga-resistentes aponta para a necessidade da avaliação da atividade antimicrobiana para selecionar o fármaco mais indicado e, assim, minimizar falhas terapêuticas na conduta clínica veterinária.

The susceptibility pattern to azithromycin of bacterial pathogens from various infectious sites, and the in vitro activity and minimum inhibitory concentration (MIC) of azithromycin were studied. Tests such as disc diffusion and broth microdilution detected respectively 48.6 percent and 55 percent of resistant Staphylococcus spp., and 55.3 percent and 72.7 percent resistant gram-negative rods. MIC50 for S. aureus was 4.0mg/mL, that for S. intermedius was 1.0mg/mL, for coagulase-negative Staphylococcus e"512mg/mL, and for gram-negative rods 256mg/mL. Fifteen percent (9/60) of oxacilin-resistant, multidrug-resistant and mecA-positive Staphylococcus spp. isolates were also azithromycin resistant. The dissemination of multidrug resistant bacteria points out to the need of antimicrobial evaluation activity in order to select the best indicated drug and thus minimizing therapeutic failures in veterinary practice.

Percepção de responsáveis e recreadores sobre diferentes representações gráficas de guia alimentar para crianças de dois a três anos / Perceptions of parents, guardians and recreators on different graphic representations of food guides for young children aged two to tree years

OBJETIVO: Conhecer a percepção de responsáveis e recreadores sobre diferentes representações gráficas de guia alimentar para crianças de dois a três anos de idade. MÉTODOS: Estudo qualitativo feito com seis recreadores e 12 responsáveis por crianças de dois a três anos de uma creche pública do Rio de Janeiro. Um questionário sociodemográfico foi aplicado e uma entrevista semi-estruturada, realizada. Mostraram-se cinco representações gráficas (roda, pirâmide, arco-íris, trenzinho e prato) para que os participantes respondessem a perguntas sobre conhecimento dos grupos alimentares, conceito de nutrição (proporcionalidade/moderação e variedade), alimentação saudável e escolhessem a figura que melhor representasse a alimentação saudável. Procedeu-se, então, à análise de conteúdo. RESULTADOS: A maioria dos responsáveis (92%) percebeu o conceito de grupos alimentares com clareza, pois reportou que os guias estavam divididos por alimentos e estes agrupados de acordo com os nutrientes. Os participantes compreenderam o conceito de proporcionalidade/moderação, porém o formato hierarquizado da pirâmide causou dificuldade de interpretação, já que apontaram os grupos no topo como os mais importantes. Os participantes salientaram a importância de incluir na dieta alimentos de todos os grupos, porém o conceito de variedade intragrupo foi compreendido por apenas dois participantes. Os entrevistados elegeram a roda como o ícone que melhor representava a alimentação saudável. CONCLUSÕES: Na elaboração de um guia alimentar, deve-se levar em consideração o entendimento dos conceitos nutricionais por parte dos indivíduos para que os objetivos propostos possam ser atingidos.

OBJECTIVE: To study the perception of parents, guardians and recreators on different graphic representations of food guides for young children aged two to three years. METHODS: Qualitative research with the participation of six recreators and 12 parents/guardians of young children aged two to three years in a public day care center of Rio de Janeiro, Brazil. Five graphic representations of nutritional concepts (circle, pyramid, rainbow, little train and plate) were shown to these adults. Then, they were questioned about food group knowledge, concepts of nutrition (proportionality, moderation and variety), healthy eating habits. After this step, they were supposed to point out the best icon to represent healthy eating habits. Analysis of the content was performed. RESULTS: Most of the parents/guardians (92%) understood well the concept of food groups as they reported that food guides were divided by foods and grouped according to nutrients. They understood the concept of proportionality/moderation; however, the hierarchic format of the pyramid led them to misinterpretation: they pointed the food groups at the top as the most important ones. Participants remarked the importance of including all food groups in the diet, but the concept of intragroup variety was only understood by two participants. Adults chose the circle as the best graphic representation for a healthy nutrition. CONCLUSIONS: The elaboration of a food guide should take into consideration the comprehension of nutritional concepts by individuals in order to achieve the goals proposed.

Identificação do limiar anaeróbio em indivíduos com diabetes tipo-2 sedentários e fisicamente ativos / Identification of the anaerobic threshold in sedentary and physically active individuals with type 2 diabetes

OBJETIVO: Comparar intensidades de limiar anaeróbio (LA) obtidas a partir do lactato, ventilação e glicemia em diabéticos tipo-2 ativos (DA) e sedentários (DS) e não-diabéticos ativos (NDA), e correlacionar variáveis metabólicas, hemodinâmicas e de composição corporal com o LA. METODOLOGIA: Grupos de DS (n= 09, 56,7 ± 11,9 anos), DA (n= 09, 50,6 ± 12,7 anos) e NDA (n= 10, 48,1 ± 10,8 anos) foram submetidos a um teste em cicloergômetro com incrementos de 15W até a exaustão. Freqüência cardíaca, pressão arterial (PA), percepção de esforço, lactato, glicemia e variáveis ventilatórias foram mensuradas nos 20seg finais de cada estágio de 3min para determinação dos limiares de lactato, ventilatório e glicêmico. RESULTADOS: As intensidades associadas ao LA identificado pelos diferentes métodos não diferiram entre si (p> 0,05). As intensidades absolutas foram menores para o grupo DS em relação aos grupos ativos (p< 0,05), não sendo observadas diferenças entre os grupos para as intensidades relativas ao consumo máximo de oxigênio ( por centoVO2 pico) e potência máxima ( por centoPpico) de ocorrência do LA. Observou-se correlação significativa entre LA e o percentual de gordura (r= -0,52), com tendência à correlação entre o LA e a glicemia ambulatorial (r= -0,33). Variáveis hemodinâmicas e LA não demonstraram correlações. CONCLUSÃO: O LA foi identificado a partir das técnicas estudadas em diabéticos tipo-2 e não-diabéticos. Apesar das diferenças entre grupos para as intensidades absolutas (Watts), a patologia pareceu não influenciar as intensidades relativas em que o LA foi observado. O LA apresentou correlação com a composição corporal e tendência a se correlacionar com a glicemia ambulatorial, sugerindo-se, com isso, o LA como um parâmetro importante na avaliação clínica destes pacientes.

OBJECTIVE: To compare anaerobic threshold (AT) intensities determined from blood lactate, blood glucose and ventilatory responses among sedentary (SD) and physically active (AD) type-2 diabetics and active non-diabetics (AND), and to correlate metabolic, hemodynamic and body composition variables with the AT. METHOD: The SD (n= 9, 56.7 ± 11.9 years), AD (n= 9, 50.6 ± 12.7 years) and AND (n= 10, 48.1 ± 10.8 years) groups performed a cycle ergometer test with increases of 15 watts every three minutes until exhaustion. Heart rate, arterial pressure, perceived exertion, blood lactate, blood glucose and ventilatory variables were measured during the last 20 seconds of each incremental stage, to determine the lactate, ventilatory and glucose thresholds. RESULTS: The AT intensities identified by the different methods did not differ from each other (p> 0.05). However, the absolute intensities were lower for SD than for the active groups (p< 0.05). No differences in intensity were found between the groups in relation to maximum oxygen consumption ( percentVO2 peak) and maximum power ( percentPpeak) at which the AT was observed. There was a significant correlation between AT and percentage fat (r= -0.52), and there was a trend towards correlation between AT and ambulatory blood glucose (r= -0.33). The hemodynamic variables did not show any correlations with AT. CONCLUSION: The AT was identified by means of the techniques studied, among type 2 diabetics and non-diabetics. Despite the differences between the groups with regard to absolute intensities (watts), diabetes did not appear to influence the relative intensities at which the AT was observed. The AT presented a correlation with body composition and a trend towards correlation with ambulatory blood glucose, thus suggesting that the AT is an important parameter in clinical assessments for such patients.

Description of electrophoretic and chromatographic hemoglobin profile of Rhinoclemmys punctularia

Studies of the hemoglobin pattern in Brazilian reptiles are important for determining ecological and phylogenetic relationships, but they are scarce. Peripheral blood samples were obtained from 7 males and 18 females of Rhinoclemmys punctularia. The hematological profile was based on the total hemoglobin and hematocrit values. The hemoglobin profile was obtained using electrophoretic procedures at different pH, isoelectric focusing, globin chain electrophoresis, and HPLC. The hematocrit (31 +/- 2%) and total hemoglobin (7.5 +/- 0.2 g/dL) values did not indicate gender variations. Alkaline pH electrophoresis of the total blood samples treated with 1% saponin demonstrated the presence of four well-defined hemoglobin fractions, one major component (fraction I), showing cathodic migration and three others faster than fraction I with anodic migration. When the samples were precipitated with chloroform, only two hemoglobin fractions were observed, similar to fractions I and III from the first procedure. Isoelectric focusing and HPLC showed the same pattern. With acid and neutral pH electrophoresis, two fractions with anodic migration were observed. The globin chain identification at alkaline pH showed two fractions, but four fractions were observed at acidic pH, suggesting that different polypeptide chains are involved in the hemoglobin molecule. The chromatographic separation of the total blood sample demonstrated that the major fraction comprised 81.9% and the minor 18.1%. The results obtained demonstrated a similarity between these hemoglobin components and those of some Chelidae reported in the literature for both land and aquatic animals, reflecting the adaptation to environmental conditions.

Dopplerfluxometria das artérias renais: valores normais das velocidades sistólica e diastólica e do índice resistivo nas artérias renais principais / Renal arteries Dopplerfluxometry: normal systolic and diastolic flow velocities and resistive index values in the main renal arteries / Renal arteries Dopplerfluxometry: normal systolic and diastolic flow velocities and resistive index values in the main renal arteries

Dopplerfluxometry of renal arteries has been used to estimate renal perfusion in humans. The aim of this study was to use Dopplerfluxometry technique to calculate the resistive index of main renal arteries in dogs, measuring their systolic and diastolic blood flow velocities. Twenty (10 males, 10 females), adult mongrel dogs, were used in this study. The dogs were submitted to Doppler sonographic evaluation of left and right main renal arteries. The systolic and diastolic blood flow velocities, expressed (in centimeters per second) as mean and standard deviation were 79.96± 8.82 and 28.86± 5.11 in the right main renal artery and 80.22± 6.99 and 29.62± 4.14 in the left main renal artery. The value of resistive index expressed as mean ± standard deviation was 0.64± 0.04 for the right main renal artery and 0.63± 0.028 in the left main renal artery.

Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function

We conducted a retrospective analysis of the influence of full doses of calcineurin inhibitors [8-10 mg kg-1 day-1 cyclosporine (N = 80), or 0.2-0.3 mg kg-1 day-1 tacrolimus (N = 68)] administered from day 1 after transplantation on the transplant outcomes of a high-risk population. Induction therapy was used in 13 percent of the patients. Patients also received azathioprine (2 mg kg-1 day-1, N = 58) or mycophenolate mofetil (2 g/day, N = 90), and prednisone (0.5 mg kg-1 day-1, N = 148). Mean time on dialysis was 79 ± 41 months, 12 percent of the cases were re-transplants, and 21 percent had panel reactive antibodies >10 percent. In 43 percent of donors the cause of death was cerebrovascular disease and 27 percent showed creatinine above 1.5 mg/dL. The incidence of slow graft function (SGF) and delayed graft function (DGF) was 15 and 60 percent, respectively. Mean time to last dialysis and to nadir creatinine were 18 ± 15 and 34 ± 20 days, respectively. Mean creatinine at 1 year after transplantation was 1.48 ± 0.50 mg/dL (DGF 1.68 ± 0.65 vs SGF 1.67 ± 0.66 vs immediate graft function (IGF) 1.41 ± 0.40 mg/dL, P = 0.089). The incidence of biopsy-confirmed acute rejection was 22 percent (DGF 31 percent, SGF 10 percent, IGF 8 percent). One-year patient and graft survival was 92.6 and 78.4 percent, respectively. The incidence of cytomegalovirus disease, post-transplant diabetes mellitus and malignancies was 28, 8.1, and 0 percent, respectively. Compared to previous studies, the use of initial full doses of calcineurin inhibitors without antibody induction in patients with SGF or DGF had no negative impact on patient and graft survival.

Relationship of cyclosporin and sirolimus blood concentrations regarding the incidence and severity of hyperlipidemia after kidney transplantation

The influence of drug concentrations on the development of persistent posttransplant hyperlipidemia was investigated in 82 patients who received cyclosporin A (CsA) and prednisone plus sirolimus (SRL) (52) or azathioprine (AZA) (30) during the first year after transplantation. Blood levels of CsA and SRL, daily doses of AZA and prednisone, and cholesterol, triglyceride, and glucose concentrations were determined during each visit (pretransplant and 30, 60, 90, 120, 180, and 360 days posttransplant). Persistent hyperlipidemia was defined as one-year average steady-state cholesterol (CavCHOL) or triglyceride (CavTG) concentrations above 240 and 200 mg/dL, respectively. Mean cholesterol and triglyceride concentrations increased after transplantation (P < 0.01) and were higher in patients receiving SRL compared to AZA (P < 0.001). Patients receiving SRL showed a significantly higher number of cholesterol (>229 or >274 mg/dL) and triglyceride (>198 or >282 mg/dL) determinations in the upper interquartile ranges. CsA and SRL interquartile ranges correlated with cholesterol concentrations (P = 0.001) whereas only SRL interquartile ranges correlated with triglyceride concentrations (P < 0.0001). Only pretransplant cholesterol concentration >205 mg/dL was independently associated with development of persistent hypercholesterolemia (CavCHOL >240 mg/dL, relative risk (RR) = 20, CI 3.8-104.6, P = 0.0004) whereas pretransplant triglyceride concentration >150 mg/dL (RR = 7.2, CI 1.6-32.4, P = 0.01) or >211 mg/dL (RR = 19.8, CI 3.6-107.9, P = 0.0006) and use of SRL (RR = 3, CI 1.0-8.8, P = 0.0049) were independently associated with development of persistent hypertriglyceridemia (CavTG >200 mg/dL). Persistent hypercholesterolemia was more frequent among patients with higher pretransplant cholesterol concentrations and was dependent on both CsA and SRL concentrations. Persistent hypertriglyceridemia was more frequent among patients with higher pretransplant triglyceride concentrations and was dependent on SRL concentrations.

Estudo dos aspectos psicológicos em mulheres inférteis / Psicological aspects in infertile women

PURPOSE: To assess the frequency of stress and anxiety levels in infertile women, and to correlate these aspects with risk factors, in order to obtain data for specific psychological guidance. METHODS: The case-control study included a total of 302 women, 152 being infertile (case group: 30.3 +/- 5.4 years), and 150 non-fertile (control group: 25.7 +/- 7.9 years). The quantitative approach involved the application of Lipp's Stress Symptoms Inventory and State-Trait Anxiety Inventory. Response variables considered were: stress frequency and anxiety scores (State and Trait). Statistical analysis was performed by using the Chi-squared and Mann-Whitney tests, and logistical regression to test associations between response variables and considered risk factors. Statistical significance was defined as p < 0.05. RESULTS: The stress was more frequent in the case group than the control group (61.8 and 36.0%, respectively), however, no significant differences were observed between groups in relation to stress phases and predominant symptoms. With respect to anxiety, there were no significant differences between case and control groups as to median state scores (39.5 and 41.0; respectively) and anxiety trait scores (44.0 and 42.0; respectively). Factors significantly associated with greater risk for high anxiety scores in the case group were: primary infertility, unawareness of the causal factor, diagnostic phase investigation, religion, lack of children from other marriages. CONCLUSIONS: It can be concluded that infertile women are more vulnerable to stress; however, they are capable of adapting to stressful events without serious physical or psychological compromising.

Preservation of graft function in low-risk living kidney transplant recipients treated with a combination of sirolimus and cyclosporine

The use of sirolimus (SRL) in combination with full doses of cyclosporin A (CsA) results in reduced one-year kidney allograft function, which is associated with shorter long-term allograft survival. We determined the effect of reduced CsA exposure on graft function in patients receiving SRL and prednisone. Ninety recipients of living kidney transplants receiving SRL (2 mg/day, po) were compared to 35 recipients receiving azathioprine (AZA, 2 mg kg-1 day-1, po). All patients also received CsA (8-10 mg kg-1 day-1, po) and prednisone (0.5 mg kg-1 day-1). Efficacy end-point was a composite of biopsy-confirmed acute rejection, graft loss, or death at one year. Graft function was measured by creatinine, creatinine clearance, and graft function deterioration between 3 and 12 months (delta1/Cr). CsA concentrations in patients receiving SRL were 26 percent lower. No differences in one-year composite efficacy end-point were observed comparing SRL and AZA groups (18 vs 20 percent) or in the incidence of biopsy-proven acute rejection (14.4 and 14.3 percent). There were no differences in mean ± SD creatinine (1.65 ± 0.46 vs 1.60 ± 0.43 mg/dl, P = 0.48) or calculated creatinine clearances (61 ± 15 vs 62 ± 13 ml/min, P = 0.58) at one year. Mean ± SD delta1/Cr (-11 ± 17 vs -14 ± 15 percent, P = 0.7) or the percentage of patients with >20 percent (26 vs 31 percent, P = 0.6) or >30 percent delta1/Cr (19 vs 17 percent, P = 1) did not differ between the two groups. The use of 2-mg fixed oral doses of SRL and reduced CsA exposure was effective in preventing acute rejection and preserving allograft function.

Retrospective study (1998-2001) on canine ehrlichiosis in Belo Horizonte, MG, Brazil

The present work describes a retrospective study of clinical cases of ehrlichiosis in dogs examined from March 1998 to September 2001. From the clinical records with laboratorial confirmation of Ehrlichia canis or E. platys infections, the following parameters were analyzed: demographic aspects (age, race, sex, period of the year and origin), clinical characteristics (body temperature, exposure to ticks and clinical signs), and hematological characteristics (blood cell counts and type of infected cell). A total of 194 clinical records were analyzed, from which 31 animals were infected with E. canis and 21 animals with E. platys. The number of cases of canine ehrlichiosis increased considerably from the year 2000 onwards, and 24.4 percent of the cases occurred in 13- to 24-month-old animals, in different urban and per-urban regions of the municipality of Belo Horizonte. The most frequent symptoms were fever, anorexia, apathy, abdominal pain, lymphadenopathy and dispnea. Regarding hematological alterations, 70.3 percent of the animals presented anemia, 50 percent presented thrombocytopenia and 30 percent leukopenia, and most E. canis morulae were seen in monocytes. The results point to the importance of canine ehrlichiosis, as 35.9 percent of the dogs with suspected hemoparasitic diseases were infected with Ehrlichia canis or E. platys

Anatomía vascular y nerviosa de la rata aplicada a la microcirugía experimental y clínica / Neurovascular anatomy of the rat applied to experimental and clinical microsurgery

En base a experiencia personal y a la medición realizada en disecciones afectuadas en 30 ratas de un peso promedio de 300 gramos, se dan conocer parámetros que tienen por finalidad orientar a aquellos que se inician en la práctica de la microcirugía. En este trabajo se señalan características anatómicas de la ratas y las vías de abordaje de vasos y nervios posibles de intervención y que tienen relación con los diámetros observados en los vasos humanos digitales y vasos de colgajos empleados. Así se señalan longitud, diámetro in situ y después de masaje de vasos ubicados en distintas regiones corporales tales como aorto, vena cava, carótida común, arteria y vena renales, arteria y vena femorales; asimismos se precisan las dificultades encontradas tales como relaciones de otros elementos, tejidos conectivo. Se especifica qué técnicas son susceptibles de realizar para cada vaso, Se señala que el único nervio susceptible de practicar neurorrafias de aplicación ulterior es el nervio isquiático. De este nervio se precisa las características de longitud, fascículos, diámetro, y la resistencia de per- y epineuro a la satura. El éxito clínico es directamente proporcional a la práctica experimental que el cirujano posea

Estudo comparativo do espermograma em portadores e näo portadores de Ureaplasma urealyticum no líquido seminal / Seminal parameters in patients with and without Ureaplasma urealyticum

Foram analisadas 47 amostras de líquido seminal com o objetivo de determinar se alteraçöes nos valores de referência do espermograma poderiam estar associadas à presença de Ureaplasma urealyticum na amostra. Observamos positividade em 24(51,1%) dos materiais examinados. Os valores de referência para vitalidade foram considerados satisfatórios em ambos os grupos. Portadores de ureaplasmas apresentaram contagem menor do número de espermatozóides em relaçäo ao grupo näo portador. A presença de títulos elevados de U. urealyticum (> ou = 10**3 CFU/ml)näo altera significativamente os valores de referência dos testes do espermograma