RESUMO
Schistosoma mansoni is 1 of the causative agents of schistosomiasis, an endemic disease in 76 countries of the world. The study of its genome, estimated to be 270 Mb, is very important to understanding schistosome biology, the mechanisms of drug resistance, and immune evasion. Repetitive elements constitute more than 40% of the S. mansoni genome and may play a role in the parasite evolution. The retrotransposons Boudicca, a long terminal repeat (LTR), and Perere 03, a non-LTR, are present in a high number in the S. mansoni genome and were localized with the use of fluorescence in situ hybridization (FISH) and primed in situ labeling (PRINS). Bacterial artificial chromosomes (BAC) clones containing the retrotransposons Boudicca and Perere 03 were selected by bioinformatic analysis and used as probes in FISH. Using metaphase chromosomes from sporocysts and the FISH and PRINS techniques, we were able to map these retrotransposons. Perere 03 was localized in the euchromatic regions of the short arm of chromosome 2 and Boudicca in the euchromatic regions of the short arm of chromosomes 2 and Z.
Assuntos
Genoma Helmíntico/genética , Retroelementos/fisiologia , Schistosoma mansoni/genética , Animais , Mapeamento Cromossômico/métodos , Cromossomos Artificiais Bacterianos/genética , Hibridização in Situ Fluorescente , Cariotipagem , Microscopia Confocal , Marcação in Situ com Primers , Alinhamento de Sequência , Sequências Repetidas TerminaisRESUMO
The use of primary angioplasty in the treatment of acute myocardial infarction (AMI), as opposed to fibrinolysis, is well established, as long as performed by an experienced team. The benefits are "time-dependent", hense the rational for the sentence "Time is Muscle". It is very important to assess the time factor, mainly if the therapeutic option is primary angioplasty, since it is necessary to set up a full range of conditions related to this type of specific treatment (human, material and logistical). In the current study was analysed the in and out of hospital time sequence of 99 patients with AMI that underwent primary PTCA during the year of 1999. The main goal was to assess if the performance of this procedure outside regular working hours could have any significant impact on the "time of in-hospital ischemia". The different time durations were prospectively recorded according to a protocol that was previously established and filled for each patient by the lab team. The authors conclude that: a) the average in-hospital time delay in the treatment of AMI by PTCA was not significantly influenced by the fact that the procedure was performed outside the regular working hours of the lab; b) the main component of the "ischemic in hospital time" corresponds to the time between the patient's admission and the decision making time for PTCA. Although the average decision making time for PTCA is too long and must be optimized, the average total in hospital ischemic time (99-105 minutes) compares favorably with other previous reports in the literature.
Assuntos
Angioplastia Coronária com Balão/tendências , Infarto do Miocárdio/terapia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
OBJECTIVES: To evaluate the association between patterns of pulmonary transvalvular and venous flows in patients with ischemic heart disease, assessed by Doppler echocardiography, and invasive measurements of left ventricular (LV) diastolic pressures. POPULATION: Thirty-seven patients with clinical diagnosis or suspicion of coronary heart disease and referred for coronary angiography; all were in sinus rhythm, and had no known valvular heart or chronic pulmonary disease. METHODS: The following were recorded during transthoracic Doppler echocardiography: acceleration time (AT) and total ejection time (ET) of right ventricular outflow; duration of the flow at atrial contraction (a duration) and duration of the "A" wave of mitral inflow (A duration). These data were correlated with the values of LV filling pressures previously obtained by cardiac catheterization. RESULTS: We found a significant correlation of LV end-diastolic pressures with the difference a-A duration (r = 0.75; p < 0.001) and also with the ratio AT/ET (r = -0.73;.
Assuntos
Cateterismo Cardíaco , Ecocardiografia Doppler , Hemodinâmica , Isquemia Miocárdica/diagnóstico por imagem , Isquemia Miocárdica/fisiopatologia , Valva Pulmonar/diagnóstico por imagem , Valva Pulmonar/fisiopatologia , Veias Pulmonares/diagnóstico por imagem , Veias Pulmonares/fisiopatologia , Função Ventricular Esquerda , Adulto , Idoso , Pressão Sanguínea , Diástole , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
1. Studies were carried out on rural workers in Brazil to determine the decrease in the activity of plasma butyrylcholinesterase (BChE), erythrocyte cholinesterase (AChE) associated with exposure to organophosphorus pesticides (OP). The goal of this work is to help prevent injury to these workers. 2. In developing countries the distance between area of pesticide use and reference laboratories is a drawback for analytical techniques, since cholinesterase activity determinations require fresh blood samples. Field methodologies can be a useful alternative to laboratory tests, however they are not as sensitive as those found in laboratories. 3. The modification of Ellman's Method presented in this paper allows blood samples to be frozen and maintain enzymatic stability: 7 days for AChE and 3 days for BChE. The proposed method is also more sensitive than Ellman's Method Modified by Magnotti (EMMM). 4. The results suggest that the Ellman Method Modified by Oliveira-Silva (EMMOS) is valid for monitoring procedures. This method represents an important contribution to the process of monitoring OP exposures, since the evaluations no longer have to be conducted near the site of OP use.
Assuntos
Acetilcolinesterase/sangue , Butirilcolinesterase/sangue , Criopreservação , Monitoramento Ambiental/métodos , Eritrócitos/enzimologia , Exposição Ocupacional/análise , Paraoxon/análogos & derivados , Estabilidade Enzimática , Eritrócitos/efeitos dos fármacos , Congelamento , Humanos , Paraoxon/farmacologia , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Organophosphorus pesticides are one of the most commonly used insecticide classes. They act through a potent inhibition of acetylcholinesterase (AChE). Many of them must undergo transformation into the corresponding oxon analogs to inhibit AChE. This study showed that a brain tissue subfraction transformed methyl parathion (O,O-dimethyl O-p-nitrophenyl phosphorothioate) in vitro. Methyl parathion activation was assayed by solvent extraction of the products followed by HPLC and GC-MS analyses and, indirectly, by the inhibition of AChE present in the incubation mixture. The lack of impairment of AChE after 2 h of incubation of the brain subfraction with methyl parathion and, alternatively, with NADPH, CO, SKF 525-A, piperonyl butoxide or nitrogen indicated that this brain subfraction transformed methyl parathion without the involvement of a mixed-function oxidative pathway. The results from HPLC analysis did not show a peak corresponding to methyl paraoxon (O,O-dimethyl O-p-nitrophenylphosphate), but showed the production of an unidentified peak which eluted nearby standard methyl parathion (retention times of 10.65 and 8.86 min, respectively). GC-MS analysis suggested that the unidentified product could be a methyl parathion isomer.
Assuntos
Encéfalo/metabolismo , Inibidores da Colinesterase/metabolismo , Inseticidas/farmacocinética , Metil Paration/farmacocinética , Acetilcolinesterase/análise , Animais , Biotransformação , Cromatografia Gasosa , Cromatografia Líquida de Alta Pressão , Inibidores das Enzimas do Citocromo P-450 , Sistema Enzimático do Citocromo P-450/metabolismo , Cromatografia Gasosa-Espectrometria de Massas , Técnicas In Vitro , Espectrometria de Massas , RatosRESUMO
STUDY OBJECTIVE: To review our eleven year experience in the implantation and follow-up of permanent Pacemakers in the paediatric age group. DESIGN: Retrospective study. SETTING: Children submitted to permanent cardiac Pacing implantation and accompanied in the Pacing Center of the Hospital de Santa Maria. PATIENTS: Children from both sexes, aged from neonate to 14 years old, with brady-dysrhythmia and indication for permanent cardiac Pacing implantation. MATERIAL AND METHODS: From November 1980 to September 1991, 16 children had permanent Pacemaker implantation. We describe the clinical and electrocardiographic characteristics of the population, mode of Pacing used, technical data from the implantation and evolution. RESULTS: One children died due to associated cardiac defect not related to the Pacemaker. The other 15 children remain in follow-up with normofunctioning Pacemakers and free of symptoms. We had to perform 11 reinterventions in 8 children due to generator or electrode problems (28,2 months reintervention interval). CONCLUSIONS: Improvements in Pacemaker technology and a careful technique of implantation can significantly reduce the morbidity associated to permanent pacemaker implantation in this age group.
Assuntos
Marca-Passo Artificial , Adolescente , Arritmias Cardíacas/epidemiologia , Arritmias Cardíacas/terapia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Marca-Passo Artificial/estatística & dados numéricos , Portugal , Estudos Retrospectivos , Fatores de TempoRESUMO
The authors selected 37 permanent pacemaker patients followed for eleven successive months, with symptomatology eventually related to the pacing system. An Holter ambulatory monitorization was performed to all of them during 24 hours. Twenty one had single chamber systems and the others double chamber. Twelve malfunctions were found in ten patients. Six due to "undersensing", 4 related to "oversensing", and 2 from loss of capture. Two patients had tachycardia pacemaker mediated. An inadequate mode of pacing was found in other two cases. Fifteen rhythm disturbances not related to the pacemaker systems were registered in thirteen patients: supra-ventricular in 9; ventricular greater than or equal to 3 degree of lown in 5; and 2nd degree A.V.B. Mobitz type I in one case. Four patients were submitted to surgical intervention in order to modify the mode of pacing. It was also necessary to reprogram ten patients. The Holter Ambulatory Electrocardiography revealed to be an important diagnostic method for the detection of intermittent malfunction of pacing systems. The occasional changes of cardiac rhythm not linked with pacing were also revealed.
Assuntos
Arritmias Cardíacas/diagnóstico , Eletrocardiografia Ambulatorial , Marca-Passo Artificial , Adulto , Idoso , Idoso de 80 Anos ou mais , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/fisiopatologia , Falha de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: to compare the relative value of Atrial Pacing and Exercise Electrocardiography in the diagnosis of Myocardial Ischaemia. DESIGN: prospective study in patients referred for coronary cineangiography. SETTING: Cineangiography and Ergonometry Departments of Cardiology Service. Santa Maria Hospital. PATIENTS: 16 patients (mean age 52.4 +/- 6.3), 13 males and 3 females. All were submitted to Atrial Pacing, Exercise Test and Coronariography. RESULTS: both tests were concordant in all cases but one, with negative Atrial Pacing, positive Exercise Test and negative Coronariography. CONCLUSIONS: Atrial Pacing compares favourably with Exercise Test in the diagnosis of Coronary Ischaemic Disease. It may constitute a valid alternative in patients unable to perform a conclusive Exercise Test.
Assuntos
Estimulação Cardíaca Artificial , Doença das Coronárias/diagnóstico , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
The authors review the cases of traumatic rectal injuries admitted to the Emergency Service of the "Hospital das Clínicas", University of São Paulo Medical School, during the period of July 1981 to July 1988. Forty-five patients (62.5%) had their injuries due to gunshot, 14 (19.4%) due to foreign bodies on the rectum, 10 (13.8%) due to blunt trauma and 3 (4.1%) due to stab wounds. The intraperitoneal rectum was injured in 32 patients (44.4%) and extraperitoneal portion of the rectum in 40 patients (55.5%). On the intraperitoneal injuries the management adopted were simple suture (14 patients), associated with a colostomy (17 patients) and in one patient the Hartmann procedure was adopted. On the extraperitoneal wounds the management adopted were rectal repair (when feasible), colostomy, distal washout and drainage. The complications rate was 27.8%, and from them, the majority (70%) were related to infectious nature. Seven patients died (9.7%), four of them as a consequence of sepsis. The morbidity and mortality of the rectal injuries were closed related to infectious complications as a consequence of late diagnosis. For this reason, the authors consider that all efforts should be employed to establish the prompt diagnosis.
Assuntos
Reto/lesões , Ferimentos Penetrantes/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Colostomia , Drenagem , Emergências , Feminino , Corpos Estranhos/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ferimentos Penetrantes/complicações , Ferimentos Penetrantes/mortalidadeRESUMO
In order to assess the value of atrial pacing in the diagnosis of myocardial ischemia, 23 patients (mean age 53 +/- 8 years), submitted to coronary angiography, were studied. Atrial Pacing at incremental frequencies was performed until the appearance of electrocardiographic changes (ST segment depression) and/or typical anginal pain. The highest frequency of stimulation was 160/min. The test was negative in four of five patients (80%) without significant obstructive coronary artery disease. Atrial pacing test was positive in 17 of 18 patients (94%) with abnormal angiography. The authors concluded that clinical and ECG abnormalities induced by atrial pacing seems to be correct indicators for the diagnosis of myocardial ischemia. This test can be an useful alternative in patients unable to perform a conclusive stress test.
Assuntos
Estimulação Cardíaca Artificial , Doença das Coronárias/diagnóstico , Cineangiografia , Doença das Coronárias/fisiopatologia , Eletrocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Eleven patients with cicatricial stenosis in the junction area of hepatic ducts were evaluated. In all patients the injury occurred during cholescystectomy and no operative cholangiography was performed. In 3 patients the injury was recognized during the initial cholecistectomy. Ten patients had been operated on at least one time to correct the injury in other Services. Four cases had duct or peritoneal drainage. There was an attempt of reanastomosis in two cases. Five patients had a bilio-digestive anastomosis performed in variable occasions. Two patients were reoperated 5 times, one patient 3 times. The others were submitted to one or 2 reoperations. There were a period of 1 to 72 months between the injury and last reoperation. Jaundice was the most common presenting manifestation since it appeared in all patient except one. Five patients had biliary cirrhosis. Roux-en-Y hepaticojejunostomy was carried out in all cases after enlarging the biliar stoma by longitudinal section on the left hepatic duct and performing a termino-terminal anastomosis. The 10 or 12 caliber Kehr drain used was taken out after the control cholangiography, carried around the second postoperative week. Concerning the long term results, one patient died of recurrent cholangitis six months after the 6th reoperation and one patient 14 months after the 4th reoperation of liver failure. Both had biliary cirrhosis. Two patients, remained assymptomatic for 60 months and 3 patients for 24, 37 and 56 months. The importance of preventing this severe complication is stressed by the authors. Patients with such lesions need be referred to specialized centers where well trained surgeons are available. The technique herein presented seems us to be a good option.