Avaliação e comparação entre métodos de mensuração de pressão arterial sistólica em gatos hígidos conscientes / Evaluation and comparison between methods of measurement of systolic blood pressure in healthy conscious cats

Após validação de dois diferentes métodos de mensuração de pressão arterial sistólica (PAS) não invasivos ou indiretos (oscilométrico e Doppler vascular) com o invasivo ou direto (cateterização arterial - padrão ouro) em 12 gatos hígidos anestesiados de mesma faixa etária, os métodos não invasivos foram avaliados e comparados em 24 gatos hígidos e conscientes, divididos em quatro grupos de idade. Em cada animal, procedeu-se à mensuração da pressão pelos métodos Doppler e oscilométrico. O método oscilométrico foi o primeiro a ser realizado, e, logo em seguida, o método Doppler. Os valores considerados foram obtidos das médias de sete medidas consecutivas para cada método, com intervalo de 30 segundos entre elas. A primeira medida e as medidas discrepantes (variação ˃ 20% PAS), obtidas com sinais óbvios de estresse e/ou com movimentação do animal, foram descartadas. Os métodos de mensuração oscilométrico e Doppler, embora tenham apresentado médias estatisticamente diferentes em todos os grupos, quando comparados em cada grupo, apresentaram uma correlação significativa, alta e positiva. Ou seja, sempre que for obtido um valor elevado por um método, o mesmo fato ocorrerá com o outro método e vice-versa. Clinicamente, a diferença observada não é relevante, uma vez que a diferença média dos valores obtida pelos dois métodos, em cada grupo, foi menor que 1,1%.(AU)

After two different validation systolic blood pressure measurement methods (PAS), not invasive or indirect (oscillometric and doppler vascular) with invasive or direct (arterial catheterization - Gold Standard) in 12 anesthetized healthy cats of the same age group, not invasive methods were evaluated and compared in 24 healthy conscious cats, divided into four age groups. In each animal, we proceeded to measure the pressure by Doppler and oscillometric methods. The oscillometric method was the first to be performed, and, shortly thereafter, the doppler method. The values considered were obtained from averages from seven consecutive measurements for each method with an interval of thirty seconds between them. The first measurement and disparate measurements (range ˃ 20% PAS) obtained with obvious signs of stress and / or animal movement were discarded. Methods of oscillometric and doppler measurement, although statistically different averages were shown in all groups when compared, each group showed a significant high positive correlation, meaning that when a high value is obtained by a method, the same occurs with the other method, and vice versa. Clinically, the observed difference is not relevant since the mean difference values obtained by the two methods, in each group was lower than 1.1%.(AU)

Key issues for sustainable urban stormwater management.

Since ancient times, it is understood that stormwater from constructed areas should be managed somehow. Waste and pollution transported by stormwater poses quantity and quality problems, affecting public health and the quality of the environment. Sanitation infrastructures in urbanized regions have different development levels and the perception of stormwater changed considerably during the centuries and especially in recent years. Still, there is an evident worldwide heterogeneity when analyzing the lack of studies on urban stormwater conducted in some Asian or African countries. Strategies for sustainable stormwater management are needed at different decision levels (political, regional or local scale, for instance) but all of them need information and a clear understanding of the possibilities that are at stake as well as the main consequences of each decision. A sound approach to stormwater management should be flexible, based on local characteristics, and should take into consideration temporal, spatial and administrative factors and law, among other issues. Economic or technical constraints define different decision scenarios. Best Management Practices should be seen as an opportunity for development and improvement of social, educational and environmental conditions in urbanized and surrounding areas. Therefore they require an ample perspective and the participation of different stakeholders. High-quality decision needs time and a fair overview of the problem: the purpose of this document is to contribute to sustainable stormwater management, informing on the most relevant factors that should be assessed and their interaction. A flowchart has been produced and is presented, indicating the most relevant steps, processes and information that should be taken into account in urban development.

Profiling of promoter occupancy by PPARalpha in human hepatoma cells via ChIP-chip analysis.

The transcription factor peroxisome proliferator-activated receptor alpha (PPARalpha) is an important regulator of hepatic lipid metabolism. While PPARalpha is known to activate transcription of numerous genes, no comprehensive picture of PPARalpha binding to endogenous genes has yet been reported. To fill this gap, we performed Chromatin immunoprecipitation (ChIP)-chip in combination with transcriptional profiling on HepG2 human hepatoma cells treated with the PPARalpha agonist GW7647. We found that GW7647 increased PPARalpha binding to 4220 binding regions. GW7647-induced binding regions showed a bias around the transcription start site and most contained a predicted PPAR binding motif. Several genes known to be regulated by PPARalpha, such as ACOX1, SULT2A1, ACADL, CD36, IGFBP1 and G0S2, showed GW7647-induced PPARalpha binding to their promoter. A GW7647-induced PPARalpha-binding region was also assigned to SREBP-targets HMGCS1, HMGCR, FDFT1, SC4MOL, and LPIN1, expression of which was induced by GW7647, suggesting cross-talk between PPARalpha and SREBP signaling. Our data furthermore demonstrate interaction between PPARalpha and STAT transcription factors in PPARalpha-mediated transcriptional repression, and suggest interaction between PPARalpha and TBP, and PPARalpha and C/EBPalpha in PPARalpha-mediated transcriptional activation. Overall, our analysis leads to important new insights into the mechanisms and impact of transcriptional regulation by PPARalpha in human liver and highlight the importance of cross-talk with other transcription factors.

Tip-1 induces filopodia growth and is important for gastrulation movements during zebrafish development.

Wnt signaling is essential during animal development and also plays important roles in pathological conditions. Two mayor pathways have been described: the beta-catenin-dependent canonical (or classical) pathway and the beta-catenin-independent non-canonical Wnt pathway. Recent binding studies suggest links between the small PDZ protein TIP-1 (Tax-1 interacting protein) to components of both Wnt pathways. We have cloned and characterized the zebrafish tip-1 gene. Whole mount in situ hybridization and semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR) indicated that zebrafish tip-1 is present as a maternal RNA and is ubiquitously expressed during early development. After 24 h of development, tip-1 expression was high in the central nervous system (CNS) whereas only weak expression was detected in the caudal regions of the zebrafish embryo. Tip-1 knockdown using antisense morpholino oligonucleotides, as well as ectopic tip-1 expression, led to elongation defects in zebrafish embryos and larvae. Both knockdown and overexpression of tip-1 resulted in a widened goosecoid (gsc) expression domain in shield stage embryos, led to an abbreviated prechordal plate, and to reduced convergent extension movements during gastrulation. We constructed a green fluorescence protein (GFP)/TIP-1 fusion protein which, when expressed in cultured fibroblasts (ZF4-cells), induced filopodia growth. Our observations indicate a role for TIP-1 in gastrulation movements and in filopodia growth induction.

Zebrafish cypher is important for somite formation and heart development.

Mammalian CYPHER (Oracle, KIA0613), a member of the PDZ-LIM family of proteins (Enigma/LMP-1, ENH, ZASP/Cypher, RIL, ALP, and CLP-36), has been associated with cardiac and muscular myopathies. Targeted deletion of Cypher in mice is neonatal lethal possibly caused by myopathies. To further investigate the role of cypher in development, we have cloned the zebrafish orthologue. We present here the gene, domain structure, and expression pattern of zebrafish cypher during development. Cypher was not present as a maternal mRNA and was absent during early development. Cypher mRNA was first detected at the 3-somite stage in adaxial somites, and as somites matured, cypher expression gradually enveloped the whole somite. Later, cypher expression was also found in the heart, in head and jaw musculature, and in the brain. We further identified 13 alternative spliced forms of cypher from zebrafish heart and skeletal muscle tissue, among them a very short form containing the PDZ domain but lacking the ZM (ZASP-like) motif and the LIM domains. Targeted gene knock-down experiments using cypher antisense morpholinos led to severe defects, including truncation of the embryo, deformation of somites, dilatation of the pericardium, and thinning of the ventricular wall. The phenotype could be rescued by a cypher form, which contains the PDZ domain and the ZM motif, but lacks all three LIM domains. These findings indicate that a PDZ domain protein is important for normal somite formation and in normal heart development. Treatment of zebrafish embryos with cyclopamine, which disrupts hedgehog signaling, abolished cypher expression in 9 somite and 15-somite stage embryos. Taken together, our data suggest that cypher may play a role downstream of sonic hedgehog, in a late stage of somite development, when slow muscle fibers differentiate and migrate from the adaxial cells.

Wet-weather urban discharges: implications from adopting the revised European Directive concerning the quality of bathing water.

Wet weather urban discharges are responsible for bathing water contamination. The proposal for a revised EU Directive concerning the quality of bathing water imposes significantly more stringent requirements for the management of bathing water quality, with particularly important repercussions on beaches subjected to short-term pollution incidents. The paper reviews the aspects from EU legislation most directly related to the problem of wet-weather discharges, placing special emphasis on the recent revision process of the Directive on bathing water quality, and evaluates the benefits of some potential solutions based on continuous modelling of a combined sewer system. Increasing the sewer system storage capacity or the STP hydraulic capacity may substantially reduce the untreated discharge volumes, but spill frequency reductions under 2 to 3 spill days per bathing season will hardly be achieved. Results show the severe strains that local rainfall patterns would place on compliance with the Commission's proposal for a revised Directive and highlight the importance of the changes introduced in the amended proposal recently approved by the Council, making it less prescriptive if adequate measures are adopted to prevent bathers' exposure to short-term pollution incidents.

Gene expression profiling of the long-term adaptive response to hypoxia in the gills of adult zebrafish.

Low oxygen levels (hypoxia) play a role in clinical conditions such as stroke, chronic ischemia, and cancer. To better understand these diseases, it is crucial to study the responses of vertebrates to hypoxia. Among vertebrates, some teleosts have developed the ability to adapt to extremely low oxygen levels. We have studied long-term adaptive responses to hypoxia in adult zebrafish. We used zebrafish that survived severe hypoxic conditions for 3 wk and showed adaptive behavioral and phenotypic changes. We used cDNA microarrays to investigate hypoxia-induced changes in expression of 15,532 genes in the respiratory organs (the gills). We have identified 367 differentially expressed genes of which 117 showed hypoxia-induced and 250 hypoxia-reduced expressions. Metabolic depression was indicated by repression of genes in the TCA cycle in the electron transport chain and of genes involved in protein biosynthesis. We observed enhanced expression of the monocarboxylate transporter and of the oxygen transporter myoglobin. The hypoxia-induced group further included the genes for Niemann-Pick C disease and for Wolman disease [lysosomal acid lipase (LAL)]. Both diseases lead to a similar intra- and extracellular accumulation of cholesterol and glycolipids. The Niemann-Pick C protein binds to cholesterol from internal lysosomal membranes and is involved in cholesterol trafficking. LAL is responsible for lysosomal cholesterol degradation. Our data suggest a novel adaptive mechanism to hypoxia, the induction of genes for lysosomal lipid trafficking and degradation. Studying physiological responses to hypoxia in species tolerant for extremely low oxygen levels can help identify novel regulatory genes, which may have important clinical implications.

Combined sewer overflow emissions to bathing waters in Portugal. How to reduce in densely urbanised areas?

The current proposal for a revised European Directive concerning the quality of bathing water significantly increases the demands for the control of wet-weather discharges. A densely urbanised combined catchment was modelled for a 19-year long rainfall series in order to assess the current situation and to evaluate the benefits of potential solutions. Storage and advanced physical-chemical treatment of stormwater in the STP may significantly contribute for the reduction of the overflow volumes but reductions of the spill frequency under 2.5 spill days per bathing season are hardly obtained. This study reveals the severe strains that the local rainfall pattern may place on the control of the frequency of wet-weather discharges, pointing to serious technical, social and economical implications, at the local and at the national level, if the current proposal for a revised European Directive on Bathing Water is enforced.

Wet weather water quality modelling of a Portuguese urban catchment: difficulties and benefits.

This paper discusses the use of water quality deterministic modelling together with an integrated approach to assess the impact of urban stormwater discharges into ephemeral watercourses, based on the study of a Portuguese catchment. The description of the main aspects, difficulties and benefits found during data collection and model calibration and verification is presented, and the associated uncertainties and errors discussed. Experimental results showed a strong short- and long-term impact of sewer discharges on rivers, and confirmed deposition, resuspension and transport of pollutants as important processes for the water quality. However, the resuspension of riverbed sediment pollutants during storms was probably more significant than the direct impact of the urban discharges. The HydroWorks model was used since it allows for the calculation of pollutant build-up on catchment surfaces and in gully pots, their wash-off, and the deposition and erosion of sediments in sewers. However, it uses several constants, which could not be independently calibrated, increasing the uncertainty already associated with the data. River flows have quite different magnitude from the sewer system overflows, which, together with the difficulties in evaluating river flow rates, makes the integrated modelling approach rather complex and costly.

Diagnostic tests and specimens used to screen for Chlamydia trachomatis in genitourinary medicine clinics in the United Kingdom.

This questionnaire study looked at the diagnostics tests and specimens used to screen for Chlamydia trachomatis in UK genitourinary medicine (GUM) clinics. Replies were received from 70% (185/265) of clinics. Half used only one site to screen women. One-third took anal swabs from patients who had anal sex and 10% took oropharyngeal swabs from patients who had oral sex. Immunoassays were used to screen men for chlamydia in 86% of the clinics and women in 88%. Only 60% of male and 62% of female immunoassays were supplemented by a second test. Six per cent of clinics used molecular technique (MT) to screen men and 4% to screen women and 4% were trying to acquire it. Culture was not available to 58% of clinics. MT was not available to 81%, 89% of which was due to non provision locally and/or cost. Only 7% of clinicians thought that using MT for screening was unnecessary. There were significant differences in the availability of the technique between large academic and small clinics. A national review of GUM strategies to screen for C. trachomatis with adequate funding is urgently needed.

Laser resurfacing: a safe and predictable method of skin resurfacing.

Skin resurfacing with lasers for skin restoration has been the most exciting advance in cosmetic surgery in the past 2 years. This method has effectively replaced chemical peel and dermabrasion as modes for skin rejuvenation, yet surprisingly, very little has been published on its effectiveness. Our aim is to delineate clear indications, methods and results of laser skin resurfacing. Laser resurfacing has evolved over the past 13 years and our current method has emerged from this experience. This method has been employed on 258 consecutive patients treated over the past 2 years. A total of 201 patients were treated for photodamaged skin, 53 for facial acne scarring and four for post-surgical scars. Each of these conditions has in common the pathological finding of contour irregularity of the involved abnormal skin. The CO2 Ultrapulse laser's advantage is the predictable ability to vaporize the upper layer of elevated skin, tighten collagen bundles and induce a local inflammatory reaction with epithelial proliferation. This paper presents a clear, concise, and conservatively oriented technique, including pre- and post-operative care of laser skin resurfacing. The technique presented is conceived to correct precisely the underlying pathological condition and can be used in conjunction with other cosmetic procedures. A total of 200 patients underwent full face resurfacing, 41 periorbital, 13 perioral and four for facial scars. Of the patients, 78% were female and 22% were male. The results of each patient were judged by an independent observer. Some 92% were found to have either an excellent or very good result; 2% were judged to be satisfactory; and 6% were from outside the region or were lost to follow-up. Minor complications included 12% transient post-inflammatory hyperpigmentation, 3% acute acne and 1% herpes type 1. There were no major complications, including hypertrophic scarring. A total of 15% required some type of secondary touch-up resurfacing. Our method of laser skin resurfacing offers a consistent method for dramatic improvement of facial skin quality for those patients with photodamage and acne scarring, while minimizing risk.

Gonorrhoea in Coventry 1991-1994: epidemiology, coinfection and evaluation of partner notification in the STD clinic.

The aim of this study is to analyse the epidemiology of gonorrhoea in the Coventry area between 1991-1994 and the implementation and outcome of partner notification. A total of 404 episodes in 382 patients comprised the study group. In Coventry, 97% of episodes were managed in the STD clinic. There was a decrease in female and heterosexual male cases from 172 cases in 1991 to 37 cases in 1994 and increase in homosexual male cases from 8 in 1991 to 13 in 1994 (P<0.0001). Chlamydial coinfection was found in 38%. Among patients with gonorrhoea, 33% were asymptomatic and 40% with gonorrhoea and chlamydia were asymptomatic. Ten per cent of index cases were asymptomatic as were 83% of contact cases (P<0.0001). The health advisers (HAs) interviewed 82% immediately and 94% at some time after diagnosis. Of the average 1.5 partners per patient identified, 0.31 partners per patient were already screened, another 0.4 partners per patient were traced, 0.37 partners per patient were not traced, and for 0.41 partners per patient notification outcome was unknown or unconfirmed. Partner notification of 278 index cases traced 163 primary or tertiary contacts, 115 were new cases of gonorrhoea.

Genital colonisation and infection with candida in heterosexual and homosexual males.

OBJECTIVES: To determine the penile, perianal, and oropharyngeal candidal colonisation rates among homosexual and heterosexual males attending an STD clinic. To determine the prevalence of balanitis and candidal balanitis in the two groups. SUBJECTS: 252 heterosexual and 210 homosexual male patients attending consecutively the STD clinic in Coventry, England. DESIGN: A prospective study recording sexual behaviour, relevant history, symptoms, and examination. Specimens for candida culture were collected from the glans penis, perianal area, and oropharynx. RESULTS: Among the 462 men studied, penile, perianal, and oropharyngeal colonisation rates were 74 (16%), 70 (15%), and 116 (25%) respectively. On examination, 47 (10%) were found to have balanitis. Of the 74 patients with penile colonisation, 26 (37%) were symptomatic and 20 (27%) had balanitis. The 223 heterosexual and the 196 homosexual males who had sexual intercourse within 3 months had comparable colonisation rates of candida on the penis, perianal area, and oropharynx. Balanitis was seen in 31 heterosexuals (14%) and candidal balanitis in 16 (7%); the incidence was significantly less in homosexuals where balanitis was seen in 12 (6%) and candidal balanitis in four (2%). CONCLUSIONS: Itching or burning sensations after sex were the most common symptoms associated with penile colonisation with candida and were present in more than one third. Candidal balanitis was commoner in those who had vaginal than those who had anal intercourse within 3 months.

Penetration depth of Ultrapulse carbon dioxide laser in human skin.

BACKGROUND: Recent technological advances have dramatically increased the use of lasers in skin resurfacing. The first high-power short-pulse laser, Ultrapulse, has found extensive use in dermatology and plastic surgery for skin resurfacing. Reports for penetration depth are at best anecdotal. To our knowledge this is the first report of histological effects of the Ultrapulse in human skin. OBJECTIVE: To determine the effect of single and repeated (two or three) Ultrapulse laser impacts on volar forearm skin. METHOD: The volar surface of the arm in four patients received in adjacent areas either one, two, or three pulses, after anesthesia. The treated areas were immediately biopsied, hematoxylin & eosin prepared, and examined. RESULTS: Increasing the number of passes correlates with increased depth of penetration and thermal ablation. No significant propagation of destructive thermal energy to adjacent tissue was noted. CONCLUSION: One impact at the tested parameters ablated most of the epidermis. Two impacts superimposed ablated the entire epidermis and the superficial papillary dermis. Three superimposed impacts penetrated to the reticular dermis.

Urinary symptoms, sexual intercourse and significant bacteriuria in male patients attending STD clinics.

OBJECTIVE: To assess the relationship between sexual behaviour, urinary symptoms, urinalysis and bacteriuria in men attending STD clinics. DESIGN: A prospective study recording sexual behaviour, urinary symptoms and collecting mid-stream urine specimens. SETTING: Two West Midlands STD clinics, UK. SUBJECTS: 1086 new male patients. RESULTS: 704 patients had had sexual intercourse (SI) within 14 days of testing, 424 had urinary symptoms and 122 had pyuria. All 13 patients with positive culture had SI < 14 days before testing, urinary symptoms and pyuria. No association was found between sexual orientation, type of SI, number of sexual partners, condom usage and bacteriuria. CONCLUSION: Bacteriuria does not behave as an STD but SI may be a factor in acquiring bacteriuria. Dysuria with or without urethral discharge is the most predictive symptom of bacteriuria. Pyuria has a high sensitivity for predicting bacteriuria among males.