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1.
Int J Occup Saf Ergon ; 29(2): 668-675, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35416130

RESUMO

Using a cobot could relieve workers of strenuous and repetitive tasks while preserving their expertise. To understand the consequences of using a cobot on the occurrence of musculoskeletal disorders (MSDs), within a theoretical framework based on activity-centred ergonomics, an example cobot used in grinding activities in a real work situation is studied. This article analyses the evolution of the biomechanical dimension of the professional gestures of grinders when using the cobot. Effort linked to tool carrying and the vibrations perceived were reduced. Repetitiveness decreased but workers did not accomplish the entirety of their task. The work postures did improve for different joints but not for all, which shows the advantage of varying the contexts of using a cobot and taking into account workers' strategy diversity. To investigate other explanatory elements of the effects on MSDs, these results must be linked to the evolution of the other dimensions of professional gestures.


Assuntos
Doenças Musculoesqueléticas , Doenças Profissionais , Robótica , Humanos , Doenças Profissionais/epidemiologia , Gestos , Ergonomia/métodos , Doenças Musculoesqueléticas/epidemiologia
2.
Appl Ergon ; 81: 102878, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31422274

RESUMO

The commitment of managers is one of the facilitators of participatory ergonomics (PE). However, to achieve this, practical practitioners' strategies vary depending on the organizational context and type of stakeholder and are poorly described in the literature. The purpose of this paper is to describe and to analyze the process and strategies that led to senior managers commitment during a decision-making intervention in a subcontracting context. A reflexive practice method was used to describe strategies implemented during a multi-site research project focusing on musculoskeletal disorders prevention in the meat processing sector. A 3 levels commitment method was developed which included: each subcontractor individually, subcontractors together, and subcontractors with their main contractor. Four strategies from the literature were firstly implemented: the creation of a steering committee, the identification of tendencies to act, the transfer of knowledge and moderation of collective discussion. An additional new strategy based on the sharing of a common interest - knife sharpening and maintenance was necessary to achieve the commitment. These results reinforce the importance of stakeholder strategies commitment in PE. A greater consideration for developing a valid framework is needed.


Assuntos
Tomada de Decisões Gerenciais , Ergonomia/métodos , Participação dos Interessados/psicologia , Indústria de Processamento de Alimentos , Humanos , Doenças Musculoesqueléticas/prevenção & controle , Doenças Profissionais/prevenção & controle
3.
Res Vet Sci ; 122: 175-178, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30529272

RESUMO

The objective of this study was to elucidate whether the use of the McLintock syringe, used to inject tuberculin in cattle in several countries and based on an intradermal inoculation by needle, may, in itself, cause skin reactions that can be interpreted as positive reactions regardless of the real tuberculosis (TB) infection status of the animals. Forty-four cattle from an officially TB-free (OTF) herd were selected for the experiment. Each animal received four inoculations [one with sterile phosphate buffer saline (PBS) with 10% of glycerol and three with bovine purified protein derivative (PPD), as performed during the single intradermal tuberculin (SIT) test], two on each side of the neck (n = 176 inoculations). Three different McLintock syringes (n = 132 inoculations, PBS and bovine PPD) and one Dermojet syringe (n = 44 inoculations, PBS) were used to carry out the inoculations. No positive reactions (increase in skin-fold thickness > 3 mm) in response to the bovine PPD or PBS inoculations were observed regardless of the syringe used. No significant differences (p > 0.05) in the skin fold thickness increase (in mm) were observed between inoculation sites. Significant differences (p < 0.05) in the skin fold thickness were observed when PPD was injected in comparison to the PBS but no differences between McLintock and Dermojet were detected when PBS was injected. The McLintock syringe did not cause reactions per se that could be misunderstood as positive in TB-free cattle demonstrating that it is not a significant factor associated with the previously reported imperfect specificity of the SIT test.


Assuntos
Doenças dos Bovinos/etiologia , Testes Intradérmicos/veterinária , Seringas/efeitos adversos , Teste Tuberculínico/veterinária , Tuberculose Bovina/diagnóstico , Animais , Bovinos , Testes Intradérmicos/efeitos adversos , Mycobacterium bovis , Sensibilidade e Especificidade , Seringas/classificação , Tuberculina , Teste Tuberculínico/instrumentação , Teste Tuberculínico/métodos , Vacinação
4.
Res Vet Sci ; 119: 56-60, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29857247

RESUMO

The objective of the study was to elucidate whether the use of the needle-free Dermojet syringe, which is based on a high pressure inoculation and is used to inject tuberculin in cattle in several countries, may, in itself, cause skin reactions that can be interpreted as positive reactions to the intradermal tests that are not, in fact, related to the real infection status of the animals. Forty-four cattle from an officially tuberculosis-free (OTF) herd were selected, and four single intradermal tuberculin (SIT) tests were performed on each animal, two on each side of the neck. Three different Dermojet (D1, D2 and D3) and one McLintock (M4) syringes were used to carry out sterile phosphate buffer saline (PBS) with 10% of glycerol and bovine PPD injections. No positive reactions to the SIT test were observed when using the D1-D3 syringes in the case of either bovine PPD or PBS. With regard to M4 (PBS), all the tests were negative when using a standard interpretation but three were positive in the case of the severe interpretation. Significant differences (p < 0.05) in the skin fold thickness measured were found only between certain Dermojet and McLintock syringes at certain inoculation sites. The results showed that the needle-free Dermojet syringe used for PPD intradermal testing in cattle did not cause significant reactions that could be misunderstood as positives.


Assuntos
Teste Tuberculínico/veterinária , Tuberculose Bovina/diagnóstico , Animais , Bovinos , Mycobacterium bovis , Seringas , Tuberculina , Teste Tuberculínico/instrumentação , Teste Tuberculínico/métodos
5.
Res Vet Sci ; 112: 214-221, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28521256

RESUMO

We evaluated the sensitivity (Se) of the single cervical intradermal tuberculin (SIT) test, two interferon-gamma (IFN-γ) assays and three different antibody detection techniques for bovine tuberculosis (bTB) diagnosis in 131 mixed beef breed cattle. The results of the diagnostic techniques performed over the whole herd, and over the animals confirmed as infected based on the presence of lesions compatible with the disease and/or M. bovis isolation were compared to determine apparent prevalence (AP) and Se. The Se of the SIT test (severe interpretation) was 63.7% (95% CI, 54.54-72.00), while the Se of the IFN-γ assays ranged between 60.2% and 92%. The proportion of infected cattle detected by the different antibody detection techniques ranged from 65.5% to 87.6%. Three of the antibody detection techniques yielded a significant higher (p<0.05) Se than that achieved with the official diagnostic techniques. In addition, the interpretation in parallel of cellular and antibody detection techniques reached the highest Se: 98.2% (95% CI, 93.78-99.51) suggesting that the use of diagnostic techniques detecting both cellular and humoral responses could be considered as an alternative in the control of bTB outbreaks in high prevalence settings.


Assuntos
Anticorpos Antibacterianos/imunologia , Mycobacterium bovis/imunologia , Teste Tuberculínico/veterinária , Tuberculose Bovina/diagnóstico , Animais , Bovinos , Interferon gama/imunologia , Sensibilidade e Especificidade , Tuberculose Bovina/epidemiologia
6.
Res Vet Sci ; 95(2): 489-94, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23714043

RESUMO

DNA-based methods have emerged as an additional tool for Brucella infection-confirmation at a herd level. However, their implementation may require the use of specialized equipment. In this context the recently developed loop-mediated isothermal amplification (LAMP) technique may constitute an additional and cost-effective tool for rapid and specific DNA detection, especially in low income areas. In the present study the usefulness of a newly developed LAMP assay aiming at the multicopy-IS711 sequence was assessed on a variety of clinical samples (n=81 from abortions and ewes; cattle, n=3; swine, n=4) that were analyzed in parallel using real-time PCR and bacteriology. Although overall sensitivities obtained with the three methods were comparable (p>0.05), our results highlighted the complementarity between bacteriology and molecular-based methods for increased sensitivity. Significant differences (p<0.05) were observed with all techniques depending on the nature of the sample. Our results demonstrate the potential of the IS711-LAMP technique for direct Brucella detection.


Assuntos
Brucella/isolamento & purificação , Brucelose/veterinária , Doenças dos Bovinos/microbiologia , Técnicas de Amplificação de Ácido Nucleico/veterinária , Doenças dos Ovinos/microbiologia , Feto Abortado/microbiologia , Aborto Animal/microbiologia , Animais , Brucelose/diagnóstico , Brucelose/microbiologia , Bovinos , Doenças dos Bovinos/diagnóstico , DNA Bacteriano/genética , Ovinos , Doenças dos Ovinos/diagnóstico
7.
Prev Vet Med ; 105(1-2): 149-54, 2012 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-22391021

RESUMO

The intradermal tuberculin tests and the interferon-gamma (IFN-γ) assay are the principal tests used worldwide for the ante-mortem diagnosis of bovine tuberculosis. The conventional reagent currently in use in these tests is purified protein derivative (PPD) tuberculin obtained from Mycobacterium bovis culture. The components of PPD are poorly characterized and difficult to standardize. To overcome this issue, antigens specific to the Mycobacterium tuberculosis complex are being studied. Here we have assessed the biological potency of ESAT-6, CFP-10 and Rv-3615c presented as peptide or recombinant protein cocktails in comparison with the standard bovine PPD used routinely in Spanish eradication campaigns. The study was performed in cattle (n=23) from a herd with natural M. bovis infection. Animals were simultaneously injected with PPD and the peptide and protein cocktails. The percentages of cattle reacting positively to single intradermal test were 60.9% (bovine PPD), 47.8% (peptide cocktail) and 60.9% (protein cocktail), with no significant difference between the actual skin fold thickness increases (p>0.05). The IFN-γ assay detected 60.9% of animals when stimulation was performed with bovine PPD, but decreased to 52.2% when stimulation was performed with the peptide cocktail and to 47.8% when stimulation was performed with the protein cocktail. However, no significant differences were found between IFN-γ responder frequencies (p>0.05). These results show a potential use of these defined reagents for in vivo tuberculosis diagnosis.


Assuntos
Testes de Liberação de Interferon-gama/métodos , Testes Intradérmicos/métodos , Mycobacterium bovis/imunologia , Proteínas Recombinantes , Teste Tuberculínico/métodos , Tuberculose Bovina/diagnóstico , Animais , Antígenos de Bactérias , Proteínas de Bactérias , Bovinos , Testes de Liberação de Interferon-gama/veterinária , Testes Intradérmicos/veterinária , Sensibilidade e Especificidade , Teste Tuberculínico/veterinária
9.
Int J Dev Biol ; 40(5): 985-95, 1996 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-8946246

RESUMO

Gap junctions permit the exchange of regulatory molecules between cells and play important roles during organogenesis. The expression pattern of the gap junction proteins connexin 26, 32, and 43 was studied by immunohistochemistry in the developing, adult, and injured rat teeth. Connexins 32 and 43, but not the connexin 26, were detected during the late stages of embryonic tooth development (bell stage). Expression of connexin 32 was predominant in epithelial cells, whereas connexin 43 was more widely distributed and found in both epithelial and mesenchymal cells. During cytodifferentiation (early postnatal stages), both connexin 32 and 43 were expressed in the epithelial-derived ameloblasts, synthesizing and secreting the enamel matrix proteins. In mesenchyme, connexin 32 was observed only in differentiating odontoblasts, while connexin 43 was expressed in both differentiating and functional odontoblasts, which secrete the dentin matrix. In adult rat teeth, connexin 26 and 43 were expressed in the odontoblastic layer at low and high levels, respectively, while connexin 32 was absent from odontoblasts. Electron microscopy showed that connexin 43 was distributed exclusively at sites of contacts between odontoblasts. However, double immunostaining combined with confocal microscopy suggested an occasional overlap between odontoblasts and calcitonin gene-related peptide-positive nerve fibers. Denervation experiments showed that the expression of connexins in dental pulp was independent of innervation, whereas in injured teeth connexin 43 was upregulated in pulpal fibroblasts. Finally, cultured dental epithelial cells expressed both connexin 32 and 43, and connexin 43 was detected in cultured pulp fibroblasts in vitro, thus mimicking the in vivo distribution pattern of connexins. These results demonstrate that connexins are involved in tooth development and suggest that a given connexin may have distinct roles during odontogenesis and tooth homeostasis.


Assuntos
Conexinas/metabolismo , Regulação da Expressão Gênica no Desenvolvimento/genética , Regeneração/fisiologia , Dente/crescimento & desenvolvimento , Animais , Diferenciação Celular , Células Cultivadas , Conexina 26 , Conexina 43/metabolismo , Junções Comunicantes/metabolismo , Imuno-Histoquímica , Microscopia Confocal , Microscopia Eletrônica , Dente Molar/crescimento & desenvolvimento , Ratos , Ratos Wistar , Proteína beta-1 de Junções Comunicantes
10.
Endocrinology ; 137(8): 3356-67, 1996 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-8754762

RESUMO

The ability of rat anterior pituitary cells to communicate through gap junctions (GJ) was studied using a fluorescent molecule, Lucifer Yellow (LY), which freely passes through GJ channels. The probe was introduced into the cell cytoplasm by using either the cut-end loading method on intact tissue, or cell microinjection on cultured cells. The identification of communicating cells was performed by immunofluorescence labeling of specific hormones in endocrine cells and of S100 protein in folliculostellate (FS) cells. Rat anterior pituitary cells in their physiological organization, i.e. in the intact tissue, exhibited a high level of coupling through GJ. LY-labeled cells were found up to 300-microns apart from its site of introduction. The communicating cells were primarily PRL cells, GH cells, and FS cells. Only a few LH, TSH, and ACTH cells were labeled with LY. Anterior pituitary cells, isolated from the rat tissue by mild protease treatment and cultured for 3 days, reestablished functional GJ as demonstrated by microinjection of LY into individual cells. By immunolabeling of specific hormones and/or S100 protein, we found a GJ coupling between FS cells, and between FS cells and endocrine cells, including PRL cells. The communication between FS cells was by far the most frequent. In conclusion, we demonstrate the presence of functional GJ between anterior pituitary cells of the same type and between anterior pituitary cells having distinct differentiated functions.


Assuntos
Comunicação Celular , Glândulas Endócrinas/fisiologia , Junções Comunicantes/fisiologia , Adeno-Hipófise/fisiologia , Animais , Células Cultivadas , Conexina 43/metabolismo , Glândulas Endócrinas/citologia , Técnica Indireta de Fluorescência para Anticorpo , Corantes Fluorescentes , Isoquinolinas , Masculino , Adeno-Hipófise/citologia , Adeno-Hipófise/metabolismo , Ratos , Ratos Sprague-Dawley , Proteínas S100/metabolismo
11.
J Cell Sci ; 108 ( Pt 7): 2609-17, 1995 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-7593302

RESUMO

Epithelial cells of the thyroid gland present an uncommon connexin expression pattern, they coexpress connexin32 and connexin43. In the present work, we have analyzed the membrane distribution of these two connexins to determine: (i) whether they co-assemble in the same gap junctions or form separate gap junctions; and (ii) whether their location is somehow related to the thyroid cell polarity. Immunofluorescence analyses of the localization of the two connexins in thyroid tissue sections revealed that connexin32 and connexin43 are located in different regions of the plasma membrane. We further analyzed the location of each of the two connexins with regard to that of the tight junction-associated protein, ZO1. Laser scanning confocal microscope observations of connexin32 or connexin43 and ZO1 double-immunolabelled thyroid cells, gave evidence for a separate localization of gap junctions made of each of these two connexins. Connexin32 gap junctions appeared as fluorescent spots scattered over the lateral membrane domain, while connexin43 gap junctions formed a meshed network superimposable with that of tight junctions in the subapical region of the cells. Western blot analyses of the distribution of connexins in thyroid plasma membrane subfractions obtained by ultracentrifugation on a sucrose gradient led to the identification of membrane sub-populations enriched in either connexin32 gap junctions or connexin43 gap junctions. Connexin32 gap junctions and connexin43 gap junctions were found to differ in their resistance to solubilization by N-lauroylsarcosine. Increasing concentrations of this detergent from 0.12% to 0.42% caused a progressive solubilization of connexin43 while connexin32 remained membrane-bound.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Conexina 43/biossíntese , Conexinas/biossíntese , Junções Comunicantes/fisiologia , Glândula Tireoide/fisiologia , Animais , Western Blotting , Membrana Celular/fisiologia , Membrana Celular/ultraestrutura , Conexina 43/análise , Conexinas/análise , Eletroforese em Gel de Poliacrilamida , Células Epiteliais , Epitélio/fisiologia , Epitélio/ultraestrutura , Técnica Indireta de Fluorescência para Anticorpo , Junções Comunicantes/ultraestrutura , Coração/fisiologia , Fígado/citologia , Fígado/fisiologia , Microscopia Confocal , Microscopia de Fluorescência , Miocárdio/citologia , Especificidade de Órgãos , Suínos , Proteína beta-1 de Junções Comunicantes
13.
Nouv Rev Fr Hematol (1978) ; 37(3): 197-9, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-7567437

RESUMO

Certain neoplasias can induce unregulated erythropoietin (EPO) secretion which results in secondary erythrocytosis. Pheochromocytoma associated with erythrocytosis constitute a rare condition, where the secondary red cell abnormality is believed to be due to tumour EPO secretion. In one such case of pheochromocytoma related erythrocytosis, quantitative determination of serum EPO by enzyme immunoassay was combined with immunohistochemical examination of tumour tissue sections to locate the site of EPO secretion. EPO levels were initially high but decreased after tumour surgery, while immunolocalization showed EPO to be secreted by the neoplastic cells.


Assuntos
Neoplasias das Glândulas Suprarrenais/metabolismo , Feocromocitoma/metabolismo , Policitemia/etiologia , Neoplasias das Glândulas Suprarrenais/complicações , Adulto , Humanos , Masculino , Feocromocitoma/complicações
14.
Endocrinology ; 135(2): 724-34, 1994 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-8033821

RESUMO

Thyroid epithelial cells cultured either as a monolayer or in the form of follicles, rapidly reconstitute functional gap junctions (Gj). We previously reported that the thyroid Gj gating is regulated by TSH. We have now performed molecular analyses of Gj proteins 1) to detect the connexin(s) (Cx) that is expressed in thyroid epithelial cells, 2) to determine whether the expression of Cx is hormonally regulated, and 3) to analyze the relationship between Cx expression and histiotypic morphogenesis, i.e. folliculogenesis. Studies were carried out on thyrocytes freshly isolated from the gland and on corresponding thyrocytes after 1-7 days in culture as monolayers or in the form of reconstituted follicles. The Cx gene transcription products were analyzed by Northern blot using specific complementary DNA probes for Cx26, Cx32, and Cx43. Cx proteins were identified and estimated by Western blot and indirect immunofluorescence using polyclonal antipeptide antibodies. Cx32 and Cx43 proteins and their corresponding messenger RNA (mRNA) were detected in thyrocytes freshly isolated from the gland. Thyrocytes contained a high amount of the 1.6-kilobase Cx32 mRNA and only traces of the 3-kilobase Cx43 transcript. No Cx26 transcripts could be detected. Thyrocytes cultured at a density of 0.2-0.5 x 10(6) cells/cm2 in the absence of TSH formed monolayers. Surprisingly, monolayer cells lost Cx32 protein within 24 h, and their Cx32 mRNA content decreased from high to barely detectable levels; Cx32 protein was no longer detected throughout the 1-week culture period. On the contrary, Cx43 mRNA and Cx43 protein rapidly increased in monolayer cells to reach very high levels within 2-4 days. Thyrocytes cultured at the same density, but in the presence of TSH also rapidly lost Cx32, but as soon as they reorganized into follicular structures, reexpressed Cx32 at a level (in terms of protein and mRNA) comparable to that found in cells freshly extracted from the gland. As observed for cell monolayers, reconstituted follicles overexpressed Cx43. The Cx43 protein and Cx43 mRNA contents of cultured thyrocytes were 20- to 50-fold higher than those found in isolated thyrocytes at the outset of culture. When thyrocytes were cultured with TSH, but at a low density (< 0.2 x 10(6) cells/cm2) to prevent follicle formation, a TSH-dependent increase in Cx43 was observed in monolayer cells. However, TSH did not cause any reexpression of Cx32.(ABSTRACT TRUNCATED AT 400 WORDS)


Assuntos
Conexina 43/genética , Conexinas/genética , Regulação da Expressão Gênica , Morfogênese , Glândula Tireoide/metabolismo , Animais , Western Blotting , Células Cultivadas , Conexina 43/análise , Conexinas/análise , Epitélio/metabolismo , Imunofluorescência , Regulação da Expressão Gênica/efeitos dos fármacos , Cinética , Morfogênese/efeitos dos fármacos , RNA Mensageiro/metabolismo , Suínos , Tireotropina/farmacologia , Proteína beta-1 de Junções Comunicantes
16.
Cah Anesthesiol ; 39(3): 153-9, 1991.
Artigo em Francês | MEDLINE | ID: mdl-1884268

RESUMO

The present study uses three techniques of autotransfusion in heart surgery under ECC: peroperative and post-ECC transfusion of blood removed after induction of anaesthesia (group I: 25 patients); postoperative transfusion of extravasated thoracic blood (group II: 24 patients) and a combination of the two (group III: 25 patients). Postoperative bleeding was comparable in all groups; A subset likely to haemorrhage made up of patients who had lost more than one litre of blood was isolated and demonstrated a reduction in the number of homologous red cell concentrates needed for the autotransfused population in comparison with the controls (2.4 +/- 2.6 vs 5.7 +/- 3.5 red cell concentrates, p less than 0.05) and was particularly marked in Group II patients who received 1.9 +/- 2.2 homologous red cell concentrates. None of the techniques caused any side-effects. Combination of the two autotransfusion techniques in heart surgery does not secure any additional advantages compared with postoperative autotransfusion alone.


Assuntos
Transfusão de Sangue Autóloga/métodos , Procedimentos Cirúrgicos Cardíacos , Circulação Extracorpórea , Feminino , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório
17.
J Clin Endocrinol Metab ; 70(3): 675-9, 1990 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-1689737

RESUMO

A prospective randomized study was performed in patients with hyperthyroid Graves' disease (GD) in order to compare long (18 months) and short term (6 months) antithyroid drug treatment on the remission rate. A therapeutic protocol was offered to all GD patients who had not been treated for this disease previously. All patients studied who followed the protocol were rechecked 2 yr after treatment was withdrawn, or earlier in the case of relapse. Of the patients having undergone long term treatment, 61.8% still were in remission 2 yr after treatment withdrawal, whereas only 41.7% of the patients treated for 6 months were in remission (P less than 0.05). Such findings clearly establish that treatment duration has a direct beneficial incidence on the remission rate. These results were confirmed by the fact that treatment for 18 months resulted in remission in 7 of 15 patients who had previously relapsed after a 6-month course of therapy. This improvement in relation to treatment duration might be due to the immunosuppressive action of carbimazole. No significant difference was observed between relapse and remission groups, regardless of treatment duration, for HLA ABDr, serum T3 and T4, and T3/T4 ratio determined before treatment. Only the thyroid-stimulating antibody levels determined at the time of diagnosis and at the end of treatment were higher in the relapse group, a difference that was relevant only globally, due to value scattering. Furthermore, thyroid-stimulating antibody levels at the end of treatment may indicate remission or, conversely, continuance of the pathological process.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Antitireóideos/uso terapêutico , Doença de Graves/tratamento farmacológico , Adulto , Anticorpos/análise , Carbimazol/uso terapêutico , Feminino , Doença de Graves/sangue , Doença de Graves/imunologia , Antígenos HLA/análise , Humanos , Masculino , Estudos Prospectivos , Distribuição Aleatória , Hormônios Tireóideos/sangue , Fatores de Tempo
20.
Arch Mal Coeur Vaiss ; 78(12): 1833-9, 1985 Nov.
Artigo em Francês | MEDLINE | ID: mdl-3936431

RESUMO

Three cases of acquired LV-RA communication during bacterial endocarditis are reported. The causal organisms were Staphylococcus aureus and Streptococcus. The endocarditis complicated aortic valve disease in 2 patients and a congenital aneurysm of the membranous interventricular septum in the third case. Perforation of the septal abscess was preceded by 1st and 2nd degree AVB in all cases associated with bursts of intrahisian tachycardia in 1 case. The clinical presentation was that of an acute VSD; LV-RA communication was diagnosed by the radiological demonstration of systolic expansion of the RA, by 2D echocardiography using constant and Doppler techniques which gave the exact diagnosis in 1 case, by oximetry showing a large left-to-right shunt situated in the RA, and finally by selective left ventriculography. Surgery is essential and urgent and comprises repair of the fistula by two patches, one atrial shown on via a right atrial approach and the other ventricular via aortotomy associated with correction of the valvular lesions. Third degree AVB is observed in all cases, due to the anatomical location of the His bundle and requires permanent pacing. Good results were observed in 2 cases with follow-up periods of 14 and 48 months respectively.


Assuntos
Endocardite Bacteriana/complicações , Septos Cardíacos , Doença Aguda , Adulto , Cardiomiopatias/diagnóstico , Cardiomiopatias/etiologia , Cardiomiopatias/cirurgia , Ecocardiografia , Emergências , Humanos , Masculino , Pessoa de Meia-Idade
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