Warming and shifts in litter quality drive multiple responses in freshwater detritivore communities.

Aquatic detritivores are highly sensitive to changes in temperature and leaf litter quality caused by increases in atmospheric CO2. While impacts on detritivores are evident at the organismal and population level, the mechanisms shaping ecological communities remain unclear. Here, we conducted field and laboratory experiments to examine the interactive effects of changes in leaf litter quality, due to increasing atmospheric CO2, and warming, on detritivore survival (at both organismal and community levels) and detritus consumption rates. Detritivore community consisted of the collector-gathering Polypedilum (Chironomidae), the scraper and facultative filtering-collector Atalophlebiinae (Leptophlebiidae), and Calamoceratidae (Trichoptera), a typical shredder. Our findings reveal intricate responses across taxonomic levels. At the organismal level, poor-quality leaf litter decreased survivorship of Polypedilum and Atalophlebiinae. We observed taxon-specific responses to warming, with varying effects on growth and consumption rates. Notably, species interactions (competition, facilitation) might have mediated detritivore responses to climate stressors, influencing community dynamics. While poor-quality leaf litter and warming independently affected detritivore larvae abundance of Atalophebiinae and Calamoceratidae, their combined effects altered detritus consumption and emergence of adults of Atalophlebiinae. Furthermore, warming influenced species abundances differently, likely exacerbating intraspecific competition in some taxa while accelerating development in others. Our study underscores the importance of considering complex ecological interactions in predicting the impact of climate change on freshwater ecosystem functioning. Understanding these emergent properties contributes to a better understanding of how detritivore communities may respond to future environmental conditions, providing valuable insights for ecosystem management and conservation efforts.

Predictability of adverse outcomes in hypertensive disorders of pregnancy: a multicenter prospective cohort study.

OBJECTIVES: To explore variables associated with adverse maternal/fetal/neonatal outcomes among pregnant/postpartum patients admitted to ICU for hypertensive disorders of pregnancy (HDP). METHODS: Multicenter, prospective, national cohort study. RESULTS: Variables independently associated with maternal/fetal/neonatal mortality among 172 patients were as follows: Acute Physiology and Chronic Health Evaluation-II (APACHE-II)(OR1.20[1.06-1.35]), gestational age (OR0.698[0.59-0.82]) and aspartate aminotransferase (AST)(OR1.004[1.001-1.006]). Positive likelihood ratio for headache, epigastric pain, and visual disturbances to predict composite adverse outcomes were 1.23(1.16-1.30), 0.76(0.59-1.02), and 1.1(0.98-1.2), respectively. CONCLUSIONS: Maternal/fetal mortality due to HDP was independently associated with severity of illness on admission, gestational age, and elevated AST. Accuracy of clinical symptoms to predict composite adverse outcomes was low.

Exotic Eucalyptus leaves are preferred over tougher native species but affect the growth and survival of shredders in an Atlantic Forest stream (Brazil).

We evaluated the effect of leaves of native and exotic tree species on the feeding activity and performance of the larvae of Triplectides gracilis, a typical caddisfly shredder in Atlantic Forest streams. Leaves of four native species that differ in chemistry and toughness (Hoffmannia dusenii, Miconia chartacea, Myrcia lineata and Styrax pohlii) and the exotic Eucalyptus globulus were used to determine food preferences and rates of consumption, production of fine particulate organic matter (FPOM), growth and survival of shredders. We hypothesized that the consumption rates of leaves of Eucalyptus and their effects on the growth and survival of shredders could be predicted by leaf chemistry and toughness. The larvae preferred to feed on soft leaves (H. dusenii and M. chartacea) independently of the content of nutrients (N and P) and secondary compounds (total phenolics). When such leaves were absent, they preferred E. globulus and did not consume the tough leaves (M. lineata and S. pohlii). In monodietary experiments, leaf consumption and FPOM production differed among the studied leaves, and the values observed for the E. globulus treatments were intermediate between the soft and tough leaves. The larvae that fed on H. dusenii and M. chartacea grew constantly over five weeks, while those that fed on E. globulus lost biomass. Larval survival was higher on leaves of H. dusenii, M. chartacea and S. pohlii than on E. globulus and M. lineata leaves. Although E. globulus was preferred over tougher leaves, long-term consumption of leaves of the exotic species may affect the abundance of T. gracilis in the studied stream. Additionally, our results suggest that leaf toughness can be a determining factor for the behavior of shredders where low-quality leaves are abundant, as in several tropical streams.

Do changes in riparian zones affect periphyton growth and invertebrate colonization on rocky substrates in Atlantic Forest streams? / As alterações nas zonas ripárias afetam o crescimento do perifíton e a colonização de substratos rochosos por invertebrados em riachos de Mata Atlântica?

We evaluated the growth of periphyton and colonization of sterilized cobbles by invertebrates in three coastal streams of the Atlantic Forest (Southeast Brazil) that differ in the conservation level of riparian zones. Because of differences in light availability and water temperature, we hypothesized the growth of periphytic algae would be higher in the most altered stream. Consequently, invertebrate assemblages would differ among streams. Cobbles with similar sizes were ashed and incubated for 7, 15, 30, 45 and 60 days in the studied streams. Despite periphyton growth was faster in the most altered stream, contents of chlorophyll-a did not differ among streams. A total of 954 individuals (98% insects) belonging to 36 taxa was found. Invertebrate density was higher and increased throughout the experiment in the preserved stream, while invertebrate biomass was higher on the initial sampling intervals (7 and 15 days). A stream effect on invertebrate assemblages was observed after the 15th day and 17 taxa were found only in the preserved stream. Leptophlebiidae (Ephemeroptera), Hydroptilidae, Helichopsychidae, Leptoceridae (Trichoptera) and Orthocladiinae (Diptera) showed specificities with the assemblages found in the preserved stream and no taxa proved to be an indicator of the assemblages found in the altered streams. These results showed that changes in the riparian zones of Atlantic Forest streams did not affect the content of chlorophyll-a on rocky substrates, but the growth of periphyton influenced the density and structural composition of invertebrate assemblages. Our findings partially support the proposed hypothesis and conform to the notion of the importance of periphyton community for the colonization of exposed substrates by invertebrates and for evaluating the consequences of anthropogenic changes in ecosystem functioning and aquatic communities.(AU)

O crescimento do perifíton e a colonização de seixos esterilizados por invertebrados foram avaliados em três riachos costeiros de Mata Atlântica (Sudeste do Brasil) que diferem no estado de conservação das zonas ripárias. Devido a diferenças na disponibilidade de luz e temperatura da água, foi hipotetizado que o crescimento das algas perifíticas seria maior no riacho mais alterado. Consequentemente, as assembleias de invertebrados iriam diferir entre os riachos. Seixos com tamanhos similares foram incinerados e incubados por 7, 15, 30, 45 e 60 dias nos riachos estudados. Apesar do crescimento do perifíton ter sido mais rápido no riacho mais alterado, os teores de clorofila-a não diferiram entre os riachos. Um total de 954 indivíduos (98% insetos) pertencentes a 36 táxons foi encontrado. A densidade de invertebrados foi maior e aumentou ao longo do experimento no riacho preservado, enquanto a biomassa de invertebrados foi maior nos intervalos iniciais de amostragem (7 e 15 dias). Um efeito dos riachos nas assembleias de invertebrados foi observado após o 15o dia e 17 táxons foram encontrados somente no riacho preservado. Leptophlebiidae (Ephemeroptera), Hydroptilidae, Helichopsychidae, Leptoceridae (Trichoptera) e Orthocladiinae (Diptera) apresentaram especificidades com as assembleias encontradas no riacho preservado e nenhum táxon foi indicador das assembleias encontradas nos riachos alterados. Estes resultados demonstraram que alterações nas zonas ripárias de riachos de Mata Atlântica não afetaram os teores de clorofila-a em substratos rochosos, mas o crescimento do perifíton influenciou a densidade e a composição estrutural das assembleias de invertebrados...(AU)

Do changes in riparian zones affect periphyton growth and invertebrate colonization on rocky substrates in Atlantic Forest streams? / As alterações nas zonas ripárias afetam o crescimento do perifíton e a colonização de substratos rochosos por invertebrados em riachos de Mata Atlântica?

We evaluated the growth of periphyton and colonization of sterilized cobbles by invertebrates in three coastal streams of the Atlantic Forest (Southeast Brazil) that differ in the conservation level of riparian zones. Because of differences in light availability and water temperature, we hypothesized the growth of periphytic algae would be higher in the most altered stream. Consequently, invertebrate assemblages would differ among streams. Cobbles with similar sizes were ashed and incubated for 7, 15, 30, 45 and 60 days in the studied streams. Despite periphyton growth was faster in the most altered stream, contents of chlorophyll-a did not differ among streams. A total of 954 individuals (98% insects) belonging to 36 taxa was found. Invertebrate density was higher and increased throughout the experiment in the preserved stream, while invertebrate biomass was higher on the initial sampling intervals (7 and 15 days). A stream effect on invertebrate assemblages was observed after the 15th day and 17 taxa were found only in the preserved stream. Leptophlebiidae (Ephemeroptera), Hydroptilidae, Helichopsychidae, Leptoceridae (Trichoptera) and Orthocladiinae (Diptera) showed specificities with the assemblages found in the preserved stream and no taxa proved to be an indicator of the assemblages found in the altered streams. These results showed that changes in the riparian zones of Atlantic Forest streams did not affect the content of chlorophyll-a on rocky substrates, but the growth of periphyton influenced the density and structural composition of invertebrate assemblages. Our findings partially support the proposed hypothesis and conform to the notion of the importance of periphyton community for the colonization of exposed substrates by invertebrates and for evaluating the consequences of anthropogenic changes in ecosystem functioning and aquatic communities.

O crescimento do perifíton e a colonização de seixos esterilizados por invertebrados foram avaliados em três riachos costeiros de Mata Atlântica (Sudeste do Brasil) que diferem no estado de conservação das zonas ripárias. Devido a diferenças na disponibilidade de luz e temperatura da água, foi hipotetizado que o crescimento das algas perifíticas seria maior no riacho mais alterado. Consequentemente, as assembleias de invertebrados iriam diferir entre os riachos. Seixos com tamanhos similares foram incinerados e incubados por 7, 15, 30, 45 e 60 dias nos riachos estudados. Apesar do crescimento do perifíton ter sido mais rápido no riacho mais alterado, os teores de clorofila-a não diferiram entre os riachos. Um total de 954 indivíduos (98% insetos) pertencentes a 36 táxons foi encontrado. A densidade de invertebrados foi maior e aumentou ao longo do experimento no riacho preservado, enquanto a biomassa de invertebrados foi maior nos intervalos iniciais de amostragem (7 e 15 dias). Um efeito dos riachos nas assembleias de invertebrados foi observado após o 15o dia e 17 táxons foram encontrados somente no riacho preservado. Leptophlebiidae (Ephemeroptera), Hydroptilidae, Helichopsychidae, Leptoceridae (Trichoptera) e Orthocladiinae (Diptera) apresentaram especificidades com as assembleias encontradas no riacho preservado e nenhum táxon foi indicador das assembleias encontradas nos riachos alterados. Estes resultados demonstraram que alterações nas zonas ripárias de riachos de Mata Atlântica não afetaram os teores de clorofila-a em substratos rochosos, mas o crescimento do perifíton influenciou a densidade e a composição estrutural das assembleias de invertebrados...

Do changes in riparian zones affect periphyton growth and invertebrate colonization on rocky substrates in Atlantic Forest streams?

ABSTRACT: We evaluated the growth of periphyton and colonization of sterilized cobbles by invertebrates in three coastal streams of the Atlantic Forest (Southeast Brazil) that differ in the conservation level of riparian zones. Because of differences in light availability and water temperature, we hypothesized the growth of periphytic algae would be higher in the most altered stream. Consequently, invertebrate assemblages would differ among streams. Cobbles with similar sizes were ashed and incubated for 7, 15, 30, 45 and 60 days in the studied streams. Despite periphyton growth was faster in the most altered stream, contents of chlorophyll-a did not differ among streams. A total of 954 individuals (98% insects) belonging to 36 taxa was found. Invertebrate density was higher and increased throughout the experiment in the preserved stream, while invertebrate biomass was higher on the initial sampling intervals (7 and 15 days). A stream effect on invertebrate assemblages was observed after the 15th day and 17 taxa were found only in the preserved stream. Leptophlebiidae (Ephemeroptera), Hydroptilidae, Helichopsychidae, Leptoceridae (Trichoptera) and Orthocladiinae (Diptera) showed specificities with the assemblages found in the preserved stream and no taxa proved to be an indicator of the assemblages found in the altered streams. These results showed that changes in the riparian zones of Atlantic Forest streams did not affect the content of chlorophyll-a on rocky substrates, but the growth of periphyton influenced the density and structural composition of invertebrate assemblages. Our findings partially support the proposed hypothesis and conform to the notion of the importance of periphyton community for the colonization of exposed substrates by invertebrates and for evaluating the consequences of anthropogenic changes in ecosystem functioning and aquatic communities.

RESUMO: O crescimento do perifíton e a colonização de seixos esterilizados por invertebrados foram avaliados em três riachos costeiros de Mata Atlântica (Sudeste do Brasil) que diferem no estado de conservação das zonas ripárias. Devido a diferenças na disponibilidade de luz e temperatura da água, foi hipotetizado que o crescimento das algas perifíticas seria maior no riacho mais alterado. Consequentemente, as assembleias de invertebrados iriam diferir entre os riachos. Seixos com tamanhos similares foram incinerados e incubados por 7, 15, 30, 45 e 60 dias nos riachos estudados. Apesar do crescimento do perifíton ter sido mais rápido no riacho mais alterado, os teores de clorofila-a não diferiram entre os riachos. Um total de 954 indivíduos (98% insetos) pertencentes a 36 táxons foi encontrado. A densidade de invertebrados foi maior e aumentou ao longo do experimento no riacho preservado, enquanto a biomassa de invertebrados foi maior nos intervalos iniciais de amostragem (7 e 15 dias). Um efeito dos riachos nas assembleias de invertebrados foi observado após o 15o dia e 17 táxons foram encontrados somente no riacho preservado. Leptophlebiidae (Ephemeroptera), Hydroptilidae, Helichopsychidae, Leptoceridae (Trichoptera) e Orthocladiinae (Diptera) apresentaram especificidades com as assembleias encontradas no riacho preservado e nenhum táxon foi indicador das assembleias encontradas nos riachos alterados. Estes resultados demonstraram que alterações nas zonas ripárias de riachos de Mata Atlântica não afetaram os teores de clorofila-a em substratos rochosos, mas o crescimento do perifíton influenciou a densidade e a composição estrutural das assembleias de invertebrados. Estas observações suportam parcialmente a hipótese proposta e estão em conformidade com a noção da importância da comunidade perifítica para a colonização de substratos expostos por invertebrados e para a avaliação das consequências das alterações antrópicas no funcionamento dos ecossistemas e nas comunidades aquáticas.

Characteristics, Outcomes, and Predictability of Critically Ill Obstetric Patients: A Multicenter Prospective Cohort Study.

OBJECTIVE: To evaluate pregnant/postpartum patients requiring ICUs admission in Argentina, describe characteristics of mothers and outcomes for mothers/babies, evaluate risk factors for maternal-fetal-neonatal mortality; and compare outcomes between patients admitted to public and private health sectors. DESIGN: Multicenter, prospective, national cohort study. SETTING: Twenty ICUs in Argentina (public, 8 and private, 12). PATIENTS: Pregnant/postpartum (< 42 d) patients admitted to ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Three hundred sixty-two patients were recruited, 51% from the public health sector and 49% from the private. Acute Physiology and Chronic Health Evaluation II was 8 (4-12); predicted/observed mortality, 7.6%/3.6%; hospital length of stay, 7 days (5-13 d); and fetal-neonatal losses, 17%. Public versus private health sector patients: years of education, 9 ± 3 versus 15 ± 3; transferred from another hospital, 43% versus 12%; Acute Physiology and Chronic Health Evaluation II, 9 (5-13.75) versus 7 (4-9); hospital length of stay, 10 days (6-17 d) versus 6 days (4-9 d); prenatal care, 75% versus 99.4%; fetal-neonatal losses, 25% versus 9% (p = 0.000 for all); and mortality, 5.4% versus 1.7% (p = 0.09). Complications in ICU were multiple-organ dysfunction syndrome (34%), shock (28%), renal dysfunction (25%), and acute respiratory distress syndrome (20%); all predominated in the public sector. Sequential Organ Failure Assessment (during first 24 hr of admission) score of at least 6.5 presented the best discriminative power for maternal mortality. Independent predictors of maternal-fetal-neonatal mortality were Acute Physiology and Chronic Health Evaluation II, education level, prenatal care, and admission to tertiary hospitals. CONCLUSIONS: Patients spent a median of 7 days in hospital; 3.6% died. Maternal-fetal-neonatal mortality was determined not only by acuteness of illness but to social and healthcare aspects like education, prenatal control, and being cared in specialized hospitals. Sequential Organ Failure Assessment (during first 24 hr of admission), easier to calculate than Acute Physiology and Chronic Health Evaluation II, was a better predictor of maternal outcome. Evident health disparities existed between patients admitted to public versus private hospitals: the former received less prenatal care, were less educated, were more frequently transferred from other hospitals, were sicker at admission, and developed more complications; maternal and fetal-neonatal mortality were higher. These findings point to the need of redesigning healthcare services to account for these inequities.

Associação da Anomalia de Ebstein com a Síndrome de Wolff-Parkinson-White: relato de caso / Association of Ebstein´s Anomaly with Wolff-Parkinson-White Syndrome: case report

Primeiramente relatada por Wilhelm Ebstein em 1866,a anomalia de Ebstein corresponde a uma doença cardíacacongênita incomum, levando a uma má formaçãoda valva tricúspide. Pode se apresentar com dispnéia,cianose, arritmias, cardiomegalia e insuficiência ventriculardireita. O ecocardiograma confirma o diagnóstico.Descrevemos o caso de uma paciente feminina, 38 anos,com hipertensão arterial sistêmica e fibromialgia, apresentandoSíndrome de Wolff-Parkinson-White associadaà anomalia de Ebstein.

First reported by Wilhelm Ebstein in 1866, Ebstein´sAnomaly is an unusual congenital cardiac disease, leadingto a tricuspid valve bad formation. It can presentsdyspnea, cyanosis, arrythmia, cardiomegaly and rightventricular failure. Echocardiography firms the diagnosis.We describe a female patient, 38 years old, withsystemic arterial hypertension and fibromyalgia, presentingWolff-Parkinson-White Syndrome associated withEbstein´s Anomaly.

Associação dos níveis de dislipidemia entre obesidade tipo I, II e III / Association of dyslipidemia levels among classes of obesity I, II and III

Introdução: a obesidade está cada vez mais presente e tem grande influência nos fatores de risco para doenças cardiovasculares, entre eles a dislipidemia. Objetivos: conhecer a associação existente entre os níveis de dislipidemia nos pacientes com obesidade tipo I, II e III através da análise de prontuários de pacientes atendidos no Ambulatório da Universidade do Extremo Sul Catarinense (UNESC) no ano de 2009. Metodologia: estudo observacional, transversal, documental, quantitativo, retrospectivo. Foram coletados dados de 89 prontuários de pacientes obesos, sendo que 62 tinham o registro dos níveis de colesterol total (CT), triglicerídeos (TGL) e HDL colesterol (HDL). O nível de LDL colesterol (LDL) foi calculado pela fórmula de Friedewald. Foram comparadas as variáveis quantitativas como idade, CT, TGL, HDL e LDL entre os três tipos de obesidade e realizada a análise de variância ANOVA. Para comparação entre variáveis qualitativas como sexo e os tipos de obesidade foi utilizado o teste de qui-quadrado de associação ou independência. Resultados: foram encontrados maiores níveis de CT, TGL e LDL nos pacientes com obesidade tipo II. No tipo I, verificou-se maiores níveis de HDL. Na obesidade tipo II os níveis de CT, TGL e LDL foram superiores ao do grupo de obesidade tipo I de maneira estatisticamente significativa. Porém, esta significância não se manteve na comparação entre os tipos I e III. Conclusão: os pacientes com obesidade tipo II tem níveis estatisticamente mais altos de TGL, CT e LDL em comparação com os de obesidade tipo I.

Introduction: obesity is increasingly present and has great influence on risk factors for cardiovascular disease, including dyslipidemia. Objectives: to get to know the association between levels of dyslipidemia and obesity classes I, II and III by examining medical records of patients treated in a Clinical Ambulatory of Catarinense Extreme South University (UNESC) , Santa Catarina in 2009. Methodology: an observational, transverse, documentary, quantitative, retrospective study. It was collected data from medical records of 89 obese patients, and 62 had record levels of Total Cholesterol (TC), HDL Cholesterol (HDL) and Triglycerides (TGL). The LDL Cholesterol (LDL) level was calculated using the Friedewald formula.1 It was compared the quantitative variables such as age, TC, TGL, HDL and LDL in the three classes of obesity using the ANOVA analysis of variance. For comparison of qualitative variables such as gender and classes of obesity, it was used the chi-square test of association or independence. Results: it was observed higher levels of TC, TGL and LDL in obesity class II. HDL was higher observed in obesity class I. The obesity class II showed statistically significant higher levels of TC, LDL and TGL than in obesity class I. However, this significance was not maintained in the comparison between classes I and III. Conclusion: patients with obesity class II have statistically higher levels of TGL, TC and LDL compared to obesity class I.

Estado nutricional e prevalência de dislipidemias em idosos

Introdução: O envelhecimento populacional aumentacada vez mais a necessidade de conhecimento dos fatoresque incidem sobre a prevalência das doenças crônicodegenerativasassociadas à idade, e, dentre estas, estãoas dislipidemias.Objetivo: O estudo objetivou verificar a relação entreestado nutricional e prevalência de dislipidemias numapopulação de idosos atendidos no município de Criciúma(SC).Métodos: Realizou-se uma pesquisa retrospectiva,descritiva em 99 prontuários escolhidos de formasistemática e aleatória de pacientes idosos atendidos entresetembro de 2002 e setembro de 2007. O estudo ocorreumediante à análise dos exames bioquímicos referentesàs lipoproteínas (triglicerídeos, colesterol total, LDL-C eHDL-C) e de peso e altura. O diagnóstico nutricional foirealizado através do índice de massa corporal e osresultados classificados segundo os pontos de corte paraindivíduos idosos propostos por KAMIMURA. Para odiagnóstico bioquímico foram considerados portadoresde dislipidemias os idosos que apresentaram resultadossuperiores ao intervalo referencial para adultos propostospela IV Diretriz Brasileira Sobre Dislipidemias ePrevenção da Aterosclerose da Sociedade Brasileira deCardiologia.Resultados: O peso médio dos idosos foi de 77,1kg,a altura de 1,60m e o IMC de 30,2kg/m2. Quanto aoestado nutricional, 70% dos idosos encontravam-se acimado peso ideal; 29% apresentavam-se eutróficos e 1%com baixo peso. Não apresentarem nenhuma dislipidemia9,23% das mulheres e 17,65% dos homens. A maiorprevalência de dislipidemia foi encontrada entre as idosasobesas.Conclusão: Relacionando o estado nutricional comas dislipidemias constatou-se uma maior prevalênciaentre as idosas obesas.

Introduction: Elderly population is rising andincreases the necessity of knowledge about risk factorsof chronic-degenerative diseases associated with age,including dyslipidemias.Objectives: To verify the relation between nutritionalstatus and the prevalence of dyslipidemias in an elderlypopulation in Criciúma city, South Brazil.Methods: A transversal study was carried out with99 randomly chosen medical records of elderly patientsbetween september 2002 and september 2007. Themedical records were analyzed in terms of lipoprotein(triglycerides, total cholesterol, LDL-C and HDL-C),weight and height. Nutritional diagnosis was conductedthrough body mass index and results were classified byKamimura cutpoint. Biochemistry diagnosis was onlyconsidered dyslipidemic elderly people with results aboveIV Brazilian Guideline for Dyslipidemia andAtherosclerosis Prevention of Brazilian Society ofCardiology.Results: In average, the weight of the elderly peoplewas 77,1kg, height 1,60m and BMI 30,2kg/m2. Aboutnutritional status, 70% were above ideal weight, 29%were eutrofics and 1% with were low-weight. In thisstudy, only 9,23% of women and 17,65% of men did notpresent any kind of dyslipidemia, and the highestprevalences were found among obese elderly women.Conclusion: Relating nutritional status withdyslipidemias, it was observed, in this study, a higherprevalence among obese elderly women.

Prevalência de síndrome metabólica nos pacientes atendidos no ambulatório médico da UNESC / Prevalence of metabolic syndrome in patients from UNESC ambulatory

Objetivo: Estimar a prevalência e verificar o perfil epidemiológico dos pacientes com o diagnóstico daSíndrome Metabólica, atendidos no Ambulatório Clínico da Universidade do Extremo Sul Catarinense (UNESC).Métodos: Foi realizado um estudo observacional, descritivo, transversal, numa amostragem de 675 prontuários para o diagnóstico de Síndrome Metabólica pelos critérios do International Diabetes Federation(IDF) que apresentavam pelo menos um critério para a suspeita clínica. As variáveis analisadas foram: idade,sexo, raça, pressão arterial, diabete melito tipo 2, índice de massa corporal, circunferência abdominal, colesteroltotal, HDL-colesterol e triglicerídeos. Para análise estatística utilizou-se o teste qui-quadrado ou de Fishere análise de variância (ANOVA One-Way) e teste t-Student, com significância de 5%. Resultados: Cento e cinquenta e sete pacientes (23,2%) preencheram os critérios para o diagnóstico de Síndrome Metabólica. Com idade média de 52,4 anos;115 (73,2%) eram mulheres; 85 (54,1%) da raça branca; 98 (63,2%) tinham sobrepeso e obesidade tipo I comincidência maior nas mulheres (75,6%); circunferência abdominal média de 98,6 cm nos homens e 103,4 cm nasmulheres; 58 (41,7%) apresentaram HDL-colesterol menor que 40 mg/dL significativamente maior nos homens - p=0,000001); 98,5% apresentaram triglicerídeos e” 150 mg/dL; colesterol médio de 230,1 mg/dL nos homens e 199,4 mg/dL( significativamente maior nos homens - p=0,005); 78 (62,3%) com hipertensão arterial sistêmica e 60 (38,2%) com diabete melito.(significativamente maior nos homens - p=0,010). Conclusão: Encontramos alta prevalência de Síndrome Metabólica entre os pacientes atendidos noAmbulatório Clínico da UNESC (157 pacientes - 23,2%), principalmente em mulheres. Os homens apresentaramsignificância estatística em relação ao HDL-colesterol baixo, hipercolesterolemia e diabete melito quando comparado às mulheres.

Objective: Estimate the prevalence and verify the epidemiologic profile of patients with Metabolic Syndromereceived in UNESC Clinical Ambulatory (University of Extreme South of Santa Catarina). Methods: It was performed an observational, descriptive and transversal study in a sample of 675 records for diagnose of Metabolic Syndrome by the criterias fromInternational Diabetes Federation (IDF) which showed al least one criteria for the clinical suspected. It was analised age, sex, race, blood pressure, diabetes mellitus type II, body mass index, abdominal circumference, totalcholesterol, HDL-cholesterol and triglycerides levels. For the statistic analysis it was used the chi-square or Fisher test and variable analysis (ANOVA One-Way) e t-Studenttest, with significance of 5%. Results: One hundred and fifty seven patients(23.2)% had diagnose of Metabolic Syndrome. With mean age of 52.4 years old; 115 (73.2%) were women; 85(54.1%) caucasian; 98 (63.2%) had 61.9% had overweight and obesity type I with more incidence in women (75.6%); mean abdominal circumference of 98.6 cm in men and 103.4 cm in women; 58 (41.7%) hadHDL-cholesterol levels lower than 40 mg/L significantly higher in men – p=0.000001); 98.5% presentedtriglycerides e”150 mg/dL; mean cholesterol of 230.1 mg/dL in men and 199.4 mg/dL (significantly higher inmen – p=0.005); 78 (62.3%) with systemic arterial hypertension and 60 (38.2%) with diabetes mellitus(significantly higher in men – p=0.010).Conclusion: We found high prevalence of Metabolic Syndrome in UNESC Clinical Ambulatory (157 patients – 23.2%), mainly in women. Men had statisticsignificance of low HDL-cholesterol,hypercholesterolemia and DM as women.

Prevalência dos fatores de risco cardiovasculares nos pacientesatendidos no ambulatório de geriatria da UNESC / Prevalence of Cardiovascular Risk Factors in Elderly Patients – South Brazil

Objetivo: Conhecer a prevalência de fatores de risco cardiovasculares nos pacientes atendidos no Ambulatóriode Geriatria da Universidade do Extremo Sul Catarinense (UNESC) entre os anos de 2005 e 2007. Método: Foi realizado um estudo transversal, documental,descritivo, retrospectivo, de abordagem quantitativa, onde foram analisados 120 prontuários de pacientes idosos que foram atendidos entre o período demarço de 2005 e setembro de 2007, no Ambulatório de Geriatria da UNESC. As variáveis coletadas foram: idade, sexo e raça, presença de hipertensão arterial e diabete melito, níveis de HDL-c, LDL-c, colesterol total e triglicerídeo, valor do IMC, presença de história familiarpara doenças cardiovasculares, e prática de atividade física regular.Resultados: A prevalência dos fatores de risco analisados foi de: sedentarismo 80%, história familiar positiva para DAC 76,7%, HAS 72,5%, obesidade 37,5%,DM 26,7%, tabagismo 6,7%, alterações nos níveis de HDL-c 19,8%, LDL-c 34,2%, colesterol total 27% e triglicerídeos 18,8%. Conclusões: A prevalência dos fatores de risco paraDAC na população de idosos atendidos no Ambulatório de Geriatria da UNESC é, de maneira geral, elevada, e as categorias associadas como fator de risco foram: mulheres, raça negra e a faixa etária entre 60 e 69 anos.Dentre os fatores de risco modificáveis, o sedentarismo foi o que apresentou a maior prevalência, seguido pela presença de história familiar positiva para DAC, HAS, obesidade, dislipidemia, DM, e, por fim, tabagismo.

Aim: To know the prevalence of cardiovascular risk factors in patients investigated in Geriatric Ambulatoryfrom Extreme South of Santa Catarina University (UNESC) between 2005 and 2007. Methods: It was realized a descriptive, retrospective, transversal study, where it was analyzed 120 records of elderly patients followed between March 2005 and September 2007, in Geriatric Ambulatory of UNESC.The collected variables were: age, sex, race, blood hypertension, and diabetes mellitus (DM); HDL-c, LDL-c, totalcholesterol and triglycerides levels; BMI value, familial history of cardiovascular disease and regular physical activity practice. Results: The prevalence of cardiovascular risk factors was: sedentarism 80%, familial history of cardiovascular disease 76,7%, blood hypertension 72,5%, obesity 37,5%, DM 26,7%, smoking 6,7%, HDL-c levelslow 19,8%, LDL-c 34,2%, total cholesterol 27% and triglycerides18,8%. Conclusions: The prevalence of cardiovascular risk factors in this population is high, and categories associated with these risk factors were women, black people and age between 60-69 years old. Among risk factorsthat can be modified, the sedentarism was the most prevalent, followed by familial history of cardiovascular disease, blood hypertension, obesity, dyslipidemia, DM and smoking.

Avaliação da doença aterosclerótica da artéria carótida em pacientes submetidos à cirurgia de revascularização miocárdica por lesão do tronco da artéria coronária esquerda / Evaluation of Carotid Artery Atherosclerotic Disease in Patients Submitted to Myocardial Revascularization Surgery with Left Coronary Artery Lesion

Objetivo: Conhecer a prevalência e severidade da doença aterosclerótica da artéria carótida em pacientes com estenose significativa do tronco da artéria coronária esquerda (TCE) submetidos à cirurgia de revascularização do miocárdio.Métodos: A população estudada consistiu em 18 pacientes submetidos à cirurgia de revascularização do miocárdio no Hospital São José de Criciúma (SC) de fevereiro de 2002 a novembro de 2006 devido à estenose no TCE. A ultra-sonografia (US) foi o exame de eleição para detectar estenose de artérias carótidas, e o cateterismo para detectar estenose do TCE. Resultados: O sexo masculino foi o mais prevalente (77,8%) e a idade média foi de 63,1 anos. O grau de estenose do TCE mais prevalente foi o de 90% em 27,8% dos pacientes. O segmento do TCE predominantemente lesado foi o terço distal em 72,2% dos casos. A US mostrou estenose em 33,3% das carótidas, independente de sua gravidade. Destes, 66,6% tinham, concomitantemente, lesão de carótida direita. Dentre os casos com aterosclerose de carótidas, metade possuía lesão bilateral e significativa (grau de estenose ≥70%). Os segmentos carotídeos mais acometidos foram o bulbo e a carótida interna em 66,6% dos casos. Conclusões: A literatura médica realça uma relação importante da doença aterosclerótica de carótidas com a lesão significativa do TCE. O rastreamento de estenose de carótidas é recomendado a todos os pacientes com aterosclerose de artérias coronárias.

Objectives: Know prevalence and severity of atherosclerotic disease of carotid artery in patients with significative stenosis of left coronary artery (LCA) submitted to myocadial revascularization surgery. Methods: The sample was composed by 18 patients submitted to myocadial evascularization surgery in São José Hospital from Criciúma, South Brazil, between February 2002 to November 2006 due to LCA stenosis. Ultrasonography (US) was the exam of choice to detect stenosis of carotid arteries and the Hearth Catheterization to detect stenosis of LCA. Results: Male sex was the most prevalent (77.8%) and the mean age was 63.1 years old. The LCA stenosis degree most prevalent was of 90% in 27.8% of patients. The LCA segment mainly lesioned was the distal third in 72.2% of the cases. US shows stenosis in 33.3% of carotids, independent of its gravity. Among this patients, 66,6% also had right carotid lesion. Between the cases with carotid atherosclerosis, half had bilateral and significative lesion (stenosis degree ≥70%). The carotid segments most affected was the bulb and internal carotid in 66.6% of the cases.Conclusions: The medical literature enhalces an important relation of carotid atherosclerotic disease with significative lesion of LCA. Screening of carotide stenosis is recommended to all patients with atherosclerosis in coronary arteries.

Fator prognóstico do infarto agudo do miocárdio com supradesnível de ST / Prognosis factor of acute myocardial infarction with ST elevation

Objetivos: Conhecer a relação entre a área cardíaca infartada observada no eletrocardiograma e os níveis séricos dos marcadores isquêmicos CPK e CK-MB com o desfecho dos pacientes.Métodos: Estudo transversal, documental, observacional e retrospectivo abrangendo 96 pacientes infartados atendidos no Hospital São José, em Criciúma, SC, no período de 2003 a 2005. As variáveis estudadas foram sexo, idade, área cardíaca infartada, nível de enzimas e desfecho dos pacientes. Resultados: Dos pacientes estudados, 73 (76,04%)eram do sexo masculino e 23 (23,96%) feminino com média de idade de 60,1 anos. Observou-se maior prevalênciada mortalidade no sexo feminino (p=0,033) e em idades mais avançadas (p=0,02). Houve maior freqüênciade infarto agudo do miocárdio na parede inferior, e maior mortalidade naqueles com lesão da parede ântero- lateral. Os níveis dos marcadores isquêmicos forammaiores no sexo feminino e nos pacientes que evoluíram para óbito, não mostrando relação com a mortalidadeem uma parede infartada específica.Conclusão: Das variáveis estudadas, sexo e idade foram estatisticamente significativas quando relacionadas com o desfecho dos pacientes. Na análise dos níveis enzimáticos em uma parede cardíaca específica, não se observou associação significativa com óbito.

Objectives: To know the relation between the infarct cardiac area detected in electrocardiogram andserum levels of the ischemic markers CPK and CKMB with outcome of the patients. Methods: Transversal, document, observational and retrospective study ranging 96 infarcted patients checked in São José Hospital in Criciúma City, SC, from 2003 to 2005. The variables studied were sex, age, infarct cardiac area, enzymes level and outcome of the patients. Results: From the studied patients, 73 (76,04%) weremale and 23 (23,96%) female, with median age of 60,05 years. It was observed more prevalence of the mortality in women (p=0,33) and in advanced ages (p=0,02). There were most frequency of acute myocardial infarction in the inferior wall and more mortality on those with ântero-lateral lesion. The ischemic markers levels werehigher in females and in patients who died, not showing relation with mortality in a specific infarcted wall. Conclusion: From the studied variables, sex and age were statistically significant when related with the outcome of the patients. In the enzymes level analysis of aspecific cardiac wall it wasn’t observed significant relation with death.

Policitemia vera: relato de caso / Polycythemia vera: case report

A policitemia vera (PV) é um transtorno mieloproliferativo das células hematopoiéticas, caracterizada poruma produção anormal e acentuada de eritrócitos, leucócitos e plaquetas. É uma doença rara, com uma incidênciade 2,3/100.000 pessoas por ano. Apresentamos um relato de caso de uma paciente de 45 anos com sintomas,sinais e achados sugestivos de policitemia vera.

The polycythemia vera is a myeloproliferative disturb from haematopoietic cells characterized by abnormal and overstated production of erythrocytes, leukocytes and platelets. It is a rare disease with an incidenceof 2.3/100.000 people per year. We present a case report of a 45 years old patient with symptoms, signs andsuggestive results of polycythemia vera.

Síndrome Cardíaca X / Cardiac Syndrome X

Embora sua etiologia permaneça desconhecida e diversos mecanismos têm sido considerados, a Síndrome Cardíaca X se caracteriza por uma exagerada resposta constritora dos vasos coronarianos. Apresenta-se com dor precordial típica e achados isquêmicos na cintilografia miocárdica ou no teste de esforço. A cinecoronariografia não mostra placas de ateroma clinicamente significativas. Descrevemos o caso de uma paciente feminina, branca, 60 anos, com hipertensão arterial sistêmica e dislipidemias, com achados clínicos e complementares sugestivos da Síndrome Cardíaca X; suas manifestações clínicas e sua importância no diagnóstico diferencial de dor precordial.

Although its etiology remains unknown and several mechanisms have been considered, Cardiac Syndrome X is characterized by an exaggerated constriction response of the small coronary vases. ItÆs showed as a typical precordial pain and isquemic findings in myocardial perfusion scintigraphy and in treadmill exercise test. Coronary angiography didn't show clinically significant atherosclerotic plaques.We describe a case of a 60 year-old female white patient with arterial hypertension, dyslipidemia with clinical and complementary findings suggestives of cardiac syndrome X case; its clinical manifestations and importance in the differencial diagnosis of precordial pain.

Gastroenterite eosinofílica: um relato de caso / Eosinophilic gastroenteritis: a case report

A seguir descreve-se um raro caso de gastroenterite eosinofílica (GEE). Paciente masculino de 16 anos se queixa de dor abdominal, diarréia e emagrecimento. Exame endoscópico revelou pangastrite enantematosa e edema no antro do estômago. A biópsia gástrica apresentou pequeno aumento do número de eosinófilos, enquanto a biópsia duodenal confirmou infiltração inflamatória intersticial constituída por numerosos eosinófilos e linfócitos, vasos congestos, leve edema intersticial e eosinófilos intravasculares. Paciente foi medicado com prednisona...

We describe a rare case of eosinophilic gastroenteritis in a young male patient with abdominal pain, diarrhea and loss of weight complains. Upper digestive endoscopy revealed pangastritis and edema in the antrum of the stomach. Gastric biopsy shows some eosinophilis, while duodenal biopsy shows intersticial inflammatory infiltration with many eosinophilics and lymphocytes, engorged blood vessel, mild intersticial edema and intravascular eosinophilics. Pacient received prednisone...

Does Barypenthus concolor Burmeister (Trichoptera: Odontoceridae) select particles of different sizes for case building?

Many species of Trichoptera larvae use organic or inorganic particles to build cases that protect them from predators. The study of the wide variety of structures produced by trichopterans is important to understand the evolution of case building behavior. The objective of this work was to investigate if larvae of Barypenthus concolor (Burmeister) are capable of selecting particles of specific sizes to build their cases. The study site was an altitudinal stream in Serra do Cipó National Park, MG, Brazil). Cases and substrate samples were collected at three sites of the stream and submitted to granulometric analyses. The average mass of each particle size found in each site was used to determine the particle size proportion present in the substrate. The proportions of particle size of each case (site I: n = 10, site II: n = 19, site III: n = 13) were also analyzed. Possible differences between the proportions of the particle sizes of the substrate and of those used by B. concolor larvae were assessed by the Chi-square test. Medium and fine gravel predominated at the three sites (>70 percent). There were no significant differences between the expected and observed particle size proportion in the cases. Therefore, B. concolor does not select specific particle sizes for case building.

Larvas de muitas espécies de Trichoptera utilizam partículas orgânicas ou inorgânicas para construir seus casulos nos quais ficam protegidas de predadores. O estudo da grande variedade de estruturas produzidas por tricópteros é muito importante para o entendimento da evolução do comportamento de construção de casulos. O objetivo deste trabalho foi investigar se larvas de Barypenthus concolor (Burmeister) são capazes de selecionar tamanhos específicos de partículas para a construção de casulos. O estudo foi realizado em um riacho de altitude no Parque Nacional da Serra do Cipó, MG. Coletaram-se casulos e amostras do substrato em três locais do riacho, para os quais foram feitas análises granulométricas. A média da massa de cada tamanho de partícula encontrada em cada local foi utilizada para a determinação das proporções dos tamanhos de partícula presentes no substrato. As proporções dos tamanhos de partícula de cada casulo (ponto I: n = 10, ponto II: n = 19, ponto III: n = 13) foram também analisadas. As possíveis diferenças entre as proporções dos tamanhos de partícula presentes e dos tamanhos de partícula utilizados pelas larvas de B. concolor foram avaliadas por meio de Qui-quadrado. Cascalho médio e fino predominaram nos três locais amostrados (>70 por cento). Não houve diferenças significativas entre as proporções esperadas e as observadas para tamanhos de partícula nos casulos. Portanto, B. concolor não seleciona tamanhos específicos de partículas para a construção de casulos.

Avaliação rápida da macrofauna associada a Eichhornia azurea (Swartz) Kunth, 1843 e Pontederia lanceolata Nutt., 1818 (Pontederiaceae) na Baía do Coqueiro, Pantanal de Poconé (MT/Brasil)

The objective of this study was to evaluate the structure and diversity of the macrofauna associated with Eichhornia azurea (Swarstz) and Pontederia lanceolata Nutt, 1818 in the Coqueiro Bay, Retiro Novo Farm, Pantanal de Poconé (MT, Brazil). Samples were collected in the dry period of 2001, in two sampling stations: station 1 (impacted) was located near the farm, and station 2 (natural) in the opposite margin. In total, 972 organisms were identified, in 48 taxa, and Dytiscidae (Coleoptera) and Chironomidae (Diptera) numerically dominated the macrofauna. The results showed differences on the composition and structure of the associated macrofauna, thus suggesting that the farm is probably influencing those communities, and that each macrophyte species possess its own associated organisms.

Avaliação rápida da macrofauna associada a Eichhornia azurea (Swartz) Kunth, 1843 e Pontederia lanceolata Nutt., 1818 (Pontederiaceae) na Baía do Coqueiro, Pantanal de Poconé (MT/Brasil)

The objective of this study was to evaluate the structure and diversity of the macrofauna associated with Eichhornia azurea (Swarstz) and Pontederia lanceolata Nutt, 1818 in the Coqueiro Bay, Retiro Novo Farm, Pantanal de Poconé (MT, Brazil). Samples were collected in the dry period of 2001, in two sampling stations: station 1 (impacted) was located near the farm, and station 2 (natural) in the opposite margin. In total, 972 organisms were identified, in 48 taxa, and Dytiscidae (Coleoptera) and Chironomidae (Diptera) numerically dominated the macrofauna. The results showed differences on the composition and structure of the associated macrofauna, thus suggesting that the farm is probably influencing those communities, and that each macrophyte species possess its own associated organisms.