Biometria e parâmetros hematológicos em tartarugas da Amazônia de um criatório comercial de Rio Branco/AC / Biometric and haematological indices in turtles from the Amazon farm in Rio Branco/AC

Com o objetivo de definir os valores biométricos e quantificar parâmetros hematológicos como hematócrito, concentração de proteínas plasmáticas totais e leucócitos totais de tartarugas da espécie Podocnemis expansa, coletou-se um mililitro de sangue da veia femoral de 60 exemplares aparentemente saudáveis. Os animais obtidos do criatório particular, Estância Terra, localizado no estado do Acre, foram classificados em seis grupos de pesos diferentes. Durante a biometria, foram tomadas medidas de peso, comprimento e largura da carapaça e do plastrão, para as análises da correlação dos parâmetros de tamanho e massa corporal entre os indivíduos do mesmo grupo. Os valores observados indicaram que o grupo 06, que inclui os animais com massa acima de 26 kg, apresentou melhor correlação entre as massas individuais de cada animal (r = 0,97) Enquanto que, o grupo 02 (massa entre 21 e 25 kg) apresentou a pior correlação entre as massas (r = 0,34). O resultado da média total de hematócrito de todos os animais deste experimento foi de 10,56%. A concentração das proteínas plasmáticas totais foi de 3,69g dL-1, e a média de leucócitos totais foi de 51466,66µL. Estes parâmetros são considerados fora do padrão quando comparados com os valores encontrados em animais saudáveis da mesma espécie. Assim, este trabalho pode contribuir com informações sobre os dados biométricos e parâmetros hematológicos de P. expansa de cativeiro e demonstra a importância do monitoramento da sanidade dos animais em cativeiro, prevenindo manifestação de enfermidades que poderão pôr em risco a saúde de todo o plantel.(AU)

The aim of this study was defined the biometric values and quantify hematological parameters such as hematocrit, concentration of total plasma proteins and total leukocytes for Podocnemis expansa, we collect one milliliter of blood from the femoral vein of 60 specimens apparently healthy. The animals were collected from a private farm, Estancia Terra, located in Rio Branco in the state of Acre, and were classified into six groups of different weights. During the collection of biometric data, weight measurements were taken, and length and width of the carapace and plastron, for the analysis of correlation between the size parameters and body mass between individuals of the same group. The values observed indicate that the group 06, which includes animals with mass above 26kg, showed the best correlation between the individual masses of each animal (R = 0.97), while the group 02 (weight 21 to 25kg) showed the worst correlation between the mass (r = 0.34). The result of the overall average hematocrit of all animals of this experiment was 10.56%. The concentration of total plasma proteins was 3,69g DL-1 and the average total number of leukocytes was 51466,66µL. These parameters are considered abnormal when compared to the values found in healthy animals of the same species. This work contributes with information about biometric data and hematological parameters of P. expansa captivity and demonstrates the importance of monitoring health, preventing diseases that may endanger the health of all animals in the farm.(AU)

Pulmonary hypertension diagnosed by right heart catheterisation in sickle cell disease.

Recent studies have recognised the importance of pulmonary hypertension (PH) in sickle cell disease (SCD). The aim of this study was to determine the prevalence and prognostic impact of PH and its features in patients with SCD. 80 patients with SCD underwent baseline clinical evaluation, laboratory testing, 6-min walk tests (6MWTs) and echocardiography. Patients with a peak tricuspid regurgitant jet velocity (TRV) of ≥ 2.5 m·s(-1) were further evaluated through right heart catheterisation (RHC) to assure the diagnosis of PH. Our study evidenced a 40% prevalence of patients with elevated TRV at echocardiography. RHC (performed in 25 out of 32 patients) confirmed PH in 10% (95% CI 3.4-16.5%) of all patients, with a prevalence of post-capillary PH of 6.25% (95% CI 0.95-11.55%) and pre-capillary PH of 3.75% (95% CI -0.4-7.9%). Patients with PH were older, had worse performance in 6MWTs, and more pronounced anaemia, haemolysis and renal dysfunction. Survival was shorter in patients with PH. Our study reinforced the use of echocardiography as a screening tool for PH in SCD and the mandatory role of RHC for proper diagnosis. Our findings confirmed the prognostic significance of PH in SCD as its association to pronounced haemolytic profile.

Schistosomiasis associated pulmonary hypertension.

Schistosomiasis is one of the most prevalent infectious diseases, endemic in more than 70 countries, mainly within the developing world. More than 200 million people might be infected worldwide; about 20 million of those might develop severe disease. The hepatosplenic form of schistosomiasis is the most prevalent form of chronic disease, characterised by the presence of periportal fibrosis and portal hypertension. Pulmonary hypertension is a well-recognised complication of hepatosplenic schistosomiasis. Recent prevalent studies revealed that schistosomiasis patients may develop precapillary and postcapillary forms of pulmonary hypertension, reinforcing the role of invasive haemodynamic measurements for the proper diagnosis. These studies also demonstrated that schistosomiasis associated pulmonary arterial hypertension may represent the most prevalent form of pulmonary arterial hypertension (PAH). Many aspects regarding the appropriate management of Sch-PAH patients still remain to be elucidated, as the use of specific PAH therapy. Although the ongoing control programmes that started within the 1980s have clearly improved the schistosomiasis cenario worldwide, Sch-PAH will be seen for decades after proper control is reached, strengthening the current need for comprehensive studies aiming to clarify the multiple mechanisms involved in the pathophysiology of this particular subgroup of PAH.

Eficácia dos coadjuvantes de higiene bucal utilizados na alimentação de cães / Effectiveness of buccal hygiene coadjutant used in the dogs feeding

Avaliou-se a utilização de coadjuvantes na diminuição da placa bacteriana e formação do cálculo dentário em 16 cães. O delineamento experimental foi casualizado com quatro tratamentos (T) e quatro repetições. Os tratamentos foram: T1- controle, T2- coadjuvante com ação mecânica, T3- coadjuvante com tripolifosfato de sódio e T4- coadjuvante com hexametafosfato de sódio. Após sete dias de adaptação, no dia anterior ao início dos tratamentos, os animais foram submetidos à remoção de cálculo dentário. O experimento teve duração de 21 dias e ao final realizaram-se as medições das placas bacterianas formadas com o uso de marcadores (fucsina). O coadjuvante somente com ação mecânica não foi efetivo em retardar o aparecimento da placa bacteriana. Os coadjuvantes com polifosfatos apresentaram uma ação efetiva e significativa na diminuição da formação do calculo dentário

The use of coadjutants in the decrease of the bacterial plate and formation of the dental calculus was evaluated in 16 dogs. The experimental design was randomized with four treatments (T) and four repetitions. The treatments were the following: 1- control; 2- coadjutant 1 (one) with mechanical action; 3- coadjutant 2 (two) with tripolyphosphate of sodium and 4- coadjutant 3 (three) with hexametaphosphate of sodium. After seven days of adaptation, on the day previous to the beginning of the treatments, the animals were submitted to the removal of dental calculus and after twenty-one days of treatment a measurement of the bacterial plaque formed through the use of markers (fucsin). The coadjutant only with mechanical action was not effective in delaying the appearance of the bacterial plaque. The coadjutant containing polyphosphates presented an effective and significant action decreasing the formation of the dental calculus

Effect of sitaxsentan treatment on quality of life in pulmonary arterial hypertension.

In recent years new therapeutic options have been developed for the management of pulmonary arterial hypertension (PAH). Sitaxsentan is an oral, once daily, highly selective endothelin A receptor antagonist that recently demonstrated a positive effect on functional capacity and haemodynamics of PAH patients. The aim of this study is to evaluate the effect of sitaxsentan in the quality of life (QOL) of PAH patients. Twenty-three patients with idiopathic PAH or PAH associated to collagen vascular diseases were evaluated at baseline and after 16 weeks of treatment with sitaxsentan 100 mg orally, once daily. 6-min walk test distance (6MWD) and QOL questionnaire (QOLQ) (SF-36) were obtained at baseline and at week 16. There was a significant improvement in functional capacity evaluated by 6MWD (472 m vs. 490 m, p = 0.03) and also in the physical component of the QOLQ (p < 0.01). Evaluating each of the domains of the SF-36 QOLQ, those more related to physical capacity presented a significant increase while the domains related to the mental component presented a trend of improvement, without reaching statistical significance. Sitaxsentan improves QOL in patients with PAH mainly through the domains related to functional capacity.

Pulmonary artery distensibility in pulmonary arterial hypertension: an MRI pilot study.

Pulmonary arterial hypertension (PAH) is a disease of the small vessels in which there is a substantial increase in pulmonary vascular resistance leading to right ventricle failure and death. Invasive haemodynamic evaluation is mandatory not only for diagnosis confirmation but also to address prognosis and eligibility for the use of calcium-channel blockers through an acute vasodilator challenge. Noninvasive surrogate response markers to the acute vasodilator test have been sought. In the present study, the relationship between pulmonary artery distensibility, assessed using magnetic resonance imaging (MRI), and response to acute vasodilator tests was investigated. In total, 19 patients diagnosed with idiopathic PAH without any specific treatment were evaluated. Within a 48-h window after pulmonary artery catheterisation, patients underwent cardiac MRI. Cardiac index, calculated after the determination (invasively and noninvasively) of cardiac output, showed excellent correlation, as did right atrial pressure and right ventricle ejection fraction. Pulmonary artery distensibility was significantly higher in responders. A receiver operating characteristic curve analysis has shown that 10% distensibility was able to differentiate responders from nonresponders with 100% sensitivity and 56% specificity. The present findings suggest that magnetic resonance imaging and pulmonary artery distensibility may be useful noninvasive tools for the evaluation of patients with pulmonary hypertension.

Splenectomy and chronic thromboembolic pulmonary hypertension.

BACKGROUND: An increased prevalence of splenectomy has been reported in patients with idiopathic pulmonary arterial hypertension. Examination of small pulmonary arteries from these subjects has revealed multiple thrombotic lesions, suggesting that thrombosis may contribute to this condition. Based on these findings, we hypothesised that splenectomy could be a risk factor for chronic thromboembolic pulmonary hypertension (CTEPH), a condition defined by the absence of thrombus resolution after acute pulmonary embolism that causes sustained obstruction of the pulmonary arteries and subsequent pulmonary hypertension. METHODS: The medical history, clinical characteristics, thrombotic risk factors and haemodynamics of 257 patients referred for CTEPH between 1989 and 1999 were reviewed. In a case-control study the prevalence of splenectomy in patients with CTEPH was compared with that of patients evaluated during the same period for idiopathic pulmonary hypertension (n=276) or for lung transplantation in other chronic pulmonary conditions (n=180). RESULTS: In patients with CTEPH, 8.6% (95% CI 5.2 to 12.0) had a history of splenectomy compared with 2.5% (95% CI 0.7 to 4.4) and 0.56% (95% CI 0 to 1.6) in cases of idiopathic pulmonary arterial hypertension and other chronic pulmonary conditions, respectively (p<0.01). CONCLUSION: Splenectomy may be a risk factor for chronic thromboembolic pulmonary hypertension.

Clinical response to sildenafil in pulmonary hypertension associated with Gaucher disease.

There are few reports of pulmonary hypertension in Gaucher disease. We report a patient who showed significant clinical improvement after treatment with sildenafil.

N-terminal-pro-brain natriuretic peptide as a haemodynamic marker in idiopathic pulmonary arterial hypertension.

Patients with idiopathic pulmonary arterial hypertension usually undergo acute vasodilator tests with nitric oxide (NO) for haemodynamic evaluation and therapeutical planning. The aim of this study was to evaluate the link between the variation of N-terminal (NT)-pro-brain natriuretic peptide (BNP) levels and haemodynamic parameters during the acute vasodilator test. A total of 22 idiopathic pulmonary arterial hypertension patients who underwent acute vasodilator tests were studied. Blood samples were collected at baseline and after 30 and 60 min of NO inhalation. NT-pro-BNP levels were measured in each sample. A receiver-operating characteristic curve was used to evaluate the capability of the NT-pro-BNP level variation during NO inhalation in recognising nonresponders. To distinguish responders from nonresponders, the increase of the NT-pro-BNP (0% as cut-off value) determined a 50% specificity and 100% sensitivity (positive predictive value of 38% and a negative predictive value of 100%). These results suggest that N-terminal-pro-brain natriuretic peptide was able to distinguish nonresponder patients with the acute vasodilator test. N-terminal-pro-brain natriuretic peptide may be an interesting additional biological tool in the evaluation of idiopathic pulmonary arterial hypertension patients.

[Demographic and spatial aspects of scorpion stings in the northwest region of Belo Horizonte City, Minas Gerais, 1993-1996]. / Aspectos demográficos e espaciais dos acidentes escorpiônicos no Distrito Sanitário Noroeste, Município de Belo Horizonte, Minas Gerais, 1993 a 1996.

This paper analyzes a total of 352 scorpion sting reports in the Northwest quarter of Belo Horizonte, Minas Gerais. Traditionally, this area has shown one of the highest case incidence rates, and the present study pointed to 10.37 stings per 10,000 inhabitants. No gender preference was observed, but most victims were 50 years of age or older. Likewise, no relationship was observed between seasonality and sting rates. According to geographic distribution analyses, the highest incidence rates were in areas with the largest scorpion populations. This preliminary descriptive evaluation is important for guidelines to prevent scorpion stings, which should obviously consider local epidemiological features.

Molecular epidemiology of human T-cell leukemia virus type I (HTLV-1) Brazil: the predominant HTLV-1s in South America differ from HTLV-ls of Japan and Africa, as well as those of Japanese immigrants and their relatives in Brazil.

To better understand the origin of human T-cell leukemia virus type l (HTLV-l) in South America, we conducted a phylogenetic study on 27 new HTLV-ls in Brazil. These were obtained from Brazilians of various ethnic origins, such as Japanese immigrants, whites, blacks and mulattos. We amplified and sequenced proviral DNAs of a part of the long terminal repeats. Phylogenetic trees revealed that all but 6 of the new isolates were not only similar to each other but also similar to HTLV-ls of other South American countries, including those from Amerindians. However, the isolates differed from the HTLV-ls of Africa and Japan. The other six isolates were from Japanese immigrants and were phylogenetically almost identical to HTLV-ls in Japan but different from the majority of South American HTLV-ls, including the other new Brazilian HTLV-ls. These findings indicate that the recent introduction of HTLV-1 from Japan is limited to Japanese immigrants. In addition, the results do not support the prevailing hypothesis that HTLV-ls in South America were introduced by blacks who were brought from Africa as slaves. Rather, these results suggest that the majority of HTLV-1s prevailing in South America have spread from Amerindians, some of whom are likely to have possessed this human retrovirus from the beginning of their settlement in South America.

Chronic use of benzodiazepines and cognitive deficit complaints: a risk factor study.

Benzodiazepines produce an anterograde amnesia after acute administration but whether their chronic use is hazardous to memory processes remains unclear. The present study analyses the risk of increasing cognitive complaints with chronic benzodiazepine use. Subjects seeking medical assistance at the General Internal Medicine Outpatient Clinic of Hospital de Clinicas de Porto Alegre, were interviewed before seeing physicians. They were asked about use of benzodiazepines, history of neurological and psychiatric diseases, use of alcohol, and deficits in remembering and learning as well as age, sex and level of education. Age (over 51 years), low level of education, a history of neurological and psychiatric diseases and use of benzodiazepines showed significant associations with cognitive complaints. After a conditional logistic regression analysis, benzodiazepine use lost its association with memory complaints. These data support the hypothesis that the chronic use of benzodiazepines does not carry a risk for cognitive deficits complaints.

Diazepam inhibits retroactive interference of memory in humans: pretreatment with naltrexone does not alter this effect.

1. In a double-blind study of the effects of diazepam and naltrexone on retroactive memory interference, 88 healthy human volunteers were asked to study a text on the 1954 World Soccer Cup and were submitted to a written questionnaire on the material 48 h later. Three hours after reading the text, 58 of the subjects were exposed to a non-factual, derogatory comment on the World Cup. 2. All subjects were given either placebo or naltrexone (50 mg) before reading the text, and either placebo or diazepam (5 mg), per os, 2 h after reading the text (1 h prior to the comment). Subjects were assigned to the different treatment groups by a double-blind design. 3. Exposure to the derogatory comment caused retroactive memory interference with the retention of material from the text. Diazepam blocked the retroactive interference and had no effect of its own on retention of the text. Pretreatment with naltrexone did not influence retention, retrograde interference, or the effect of diazepam on these variables. 4. The results obtained here extend to healthy adult humans observations made on rats and mice in which diazepam blocked retroactive memory interference.

Diazepam inhibits retroactive interference of memory in humans: pretreatment with naltrexone does not alter this effect

1. In a double-blind of the effects of diazepam and naltrexone on retroactive memory interference, 88 health human volunteers were asked to study a text on the 1954 world Soccer Cup and were submitted to a written questionnaire on the material 48 h later. Three hours reading the text, 58 of the subjects were exposed to a non-factual, derogatory comment on the worls Cup. 2. All subjects were given either placebo or naltrexone (50 mg) before reading the text, and either placebo or diazepam (5 mg), per os, 2h after reading the text (1 h prior to the comment), Subjects were assigned to the different treatment groups by a double-blind design. 3. Exposure to the derogatory comment caused retroactive memory interference with the retention of material from the text. Diazepam blocked the retroactive interference and had no effect of its own on retention of the text. Pretreatment with naltrexone did not influence retention, retrograde interference, or the effect of diazepam on these variables. 4. The results obtained here extend to health adult humans observations made on rats and mice in which diazepam blocked retroactive interference