Electrocardiographic characterization in Trypanosoma cruzi reinfected mice.

Chagas' disease, caused by Trypanosoma cruzi, affects approximately 20 million people. There are 3 stages in the disease: acute, intermediate and chronic, the diversity and severity of the symptoms range from a mild electrocardiographic alteration to sudden death. We have previously demonstrated that when reinfections were carried out in the acute phase they produce greater cardiac damage. The aim of the present work was to investigate whether T. cruzi reinfected mice present electrocardiographic abnormalities that could be characteristic and only achieved after reinfections. Of the mice reinfected during the acute phase 100% showed abnormalities from days 90 post-infection, with a predominance of auricle ventricle blocks (67-71%). All the mice reinfected during the chronic infection showed electrocardiographic alteration after 30 days post-first reinfection. Of the mice infected, without reinfection, 60% exhibited electrocardiographic dysfunction at 90 days post-infection. Our results demonstrated that when the host was reinfected in the acute phase, more serious electrocardiographic alterations were developed than when the reinfections were carried out in the chronic stage. Sudden death described in some chagasic patients, might be related to some of the findings described here.

Hemostatic technique: extracapsular prostatic adenomectomy.

PURPOSE: We describe extracapsular prostatectomy performed by applying lateral capsular transfixing sutures after adenoma enucleation and minimum operative hemorrhage. MATERIALS AND METHODS: A total of 117 patients with prostatic hypertrophy underwent surgery. After adenomectomy transfixing sutures were placed at the 3 and 9 o'clock positions clockwise around the prostatic capsule (hila). Five variables were used to quantify intraoperative and postoperative hemorrhage. RESULTS: Average intraoperative blood loss was 175 cc and average minimal decrease in hematocrit was 3.9%. Most patients had postoperative bleeding through the urethral and suprapubic catheters. CONCLUSIONS: Extracapsular prostatectomy with the application of lateral capsular transfixing sutures causes minimum operative hemorrhage.

Thioridazine treatment modifies the evolution of Trypanosoma cruzi infection in mice.

Thioridazine, a tricyclic drug, is known to have a direct effect on Trypanosoma cruzi, disrupting the parasites' mitochondria and kinetoplasts. In the present study, the drug was used orally, at 80 mg/kg.day for 3 days, to treat mice inoculated with low numbers of T. cruzi. The drug caused no apparent toxicity in the host. It cleared trypomastigotes from the bloodstream, prevented the histological and functional alterations of the heart normally observed in the chronic phase of the experimental disease, and greatly reduced the mortality rate compared with that in untreated, infected controls. When checked 135 days post-infection, the density of cardiac beta receptors and the cardiac histology of the treated mice were indistinguishable from those of uninfected, untreated controls. The drug is already used to treat humans, as a neuroleptic drug. It appears to be able to prevent acute infection with T. cruzi evolving into chronic disease, at least in mice, and may be a useful base from which to design new agents for the treatment of Chagas disease.

Effects of diclofenac sodium and He:Ne laser irradiation on plasmatic fibrinogen levels in inflammatory processes.

OBJECTIVE: The aim of the present work was to determine the possible synergic effect on the concentration of plasma fibrinogen (PF) by injecting diclofenac sodium associated with laser therapy postsurgery. SUMMARY BACKGROUND DATA: Nonsteroidal anti-inflammatory drugs (NSAIDs) and He:Ne laser irradiation as a therapy were used to inhibit the effects generated by inflammation. Tissue injury produces significant increases in PF levels, which are reduced to normal values by administration of NSAIDs or laser irradiation of the injured zone. MATERIALS AND METHODS: Rate were divided into groups in which different presurgical and postsurgical treatment were used; the inflammation was induced by laparotomy. RESULTS: Parenteral diclofenac or He:Ne laser irradiation used separately in normal rats did not produce changes in the PF levels. Diclofenac and laser irradiation combined postsurgery produced a significant reduction of PF levels compared with normal values, or with groups that were injected or irradiated postsurgically. CONCLUSION: The inflammatory response could be reduced by the effect of the diclofenac sodium upon the COX-2/COX-1 inhibitory relation associated with the photobiological effect of the He:Ne laser.

Tecnica hemostatica en adenomectomia prostatica extracapsular / Prostatic technique in extracapsular prostatic adenomectomy

Los autores describen una experiencia con una técnica hemostática de adenomectomía vesicocapsular de abordaje extracapsular. Fueron intervenidos 117 pacientes; el sangrado intraoperatorio fue de 100 a 250 ml (promedio de 150 ml) y los pacientes no necesitaron transfusión sanguínea. De acuerdo con estos resultados las operaciones se acompañaron de menor sangrado intra y postoperatorio. Se evitaron las transfusion es sanguíneas y por lo tanto sus posibles complicaciones

Tecnica hemostatica en adenomectomia prostatica extracapsular / Prostatic technique in extracapsular prostatic adenomectomy

Los autores describen una experiencia con una técnica hemostática de adenomectomía vesicocapsular de abordaje extracapsular. Fueron intervenidos 117 pacientes; el sangrado intraoperatorio fue de 100 a 250 ml (promedio de 150 ml) y los pacientes no necesitaron transfusión sanguínea. De acuerdo con estos resultados las operaciones se acompañaron de menor sangrado intra y postoperatorio. Se evitaron las transfusion es sanguíneas y por lo tanto sus posibles complicaciones(AU)

In vitro synthesis of prostaglandin E2 by synovial tissue after helium-neon laser radiation in rheumatoid arthritis.

This paper reports the effect of helium-neon laser radiation (power of 5 mW and 632.8 nm wave length) on the synthesis of PGE2 in vitro in synovial tissue of biopsy samples of knee joints in patients with chronic rheumatoid arthritis stages II or III. Twelve patients were studied. Each patient received 15 applications of He-Ne laser. Eleven points for He-Ne laser applications were selected in one of the affected knees. The energy density used was 8 J/cm2 per application point. The He-Ne laser therapy reduced the synthesis of PGE2. The analysis of the data revealed a statistically significant difference between the levels of the synthesis of PGE2 before treatment (17.69 +/- 2.65 ng mg-1 of dry tissue h-1) and after treatment (13.85 +/- 2.73 ng mg-1 of dry tissue h-1), with p < 0.01 comparing mean values. This was also accompanied by relief of pain (91.6%), and a favorable subjective report from the patient. We conclude that PGE2 is a quantifiable parameter that could explain what causes pain relief in patients with rheumatoid arthritis that are treated with He-Ne laser.

Cardiac beta receptors' density or affinity modified by different Trypanosoma cruzi amount.

Chagas' disease presents complex physiopathogenic mechanism, many of them poorly understood, that in our country generally produce cardiac lesions. The acute phase related with the presence of the parasite is usually asymptomatic. This report studies if the amount of T. cruzi that induced acute infection could modify the myocardiopathy evolution. Previous works have shown that Albino Swiss mice inoculated with 45 tripomastigotes (AcL) presented alterations in the cardiac pharmacological response to adrenergic agonist and antagonist studied at 30 days post-infection (p.i). Mice inoculated with 7 x 10(4) parasites/animal showed similar behaviour at 7 days p.i. We studied the involvement of the affinity and density of cardiac beta receptors in both acute groups by binding with 3H/DHA. The AcH group presented less cardiac beta receptors number (p < 0.001), but their affinity was conserved. The AcL model presented significantly less affinity (p < 0.01) but density was not different from non infected animals. beta receptors' affinity of both infected groups were similar, but AcH density was significantly diminished when compared with AcL. These studies demonstrates that the amount of T. cruzi received by the host determines and acelerates the evolution of the chagasic myocardiopathy.

Cardiac beta-receptors in experimental Chagas' disease.

Experimental Chagas' disease (45 to 90 days post-infection) showed serious cardiac alterations in the contractility and in the pharmacological response to beta adrenergic receptors in normal and T. cruzi infected mice (post-acute phase). Chagasic infection did not change the beta receptors density (78.591 +/- 3.125 fmol/mg protein and 73.647 +/- 2.194 fmol/mg protein for controls) but their affinity was significantly diminished (Kd = 7.299 +/- 0.426 significantly diminished (Kd = 7.299 +/- 0.426 nM and Kd = 3.759 +/- 0.212 nM for the control) p < 0.001. This results demonstrate that the alterations in pharmacological response previously reported in chagasic myocardium are related to a significantly less beta cardiac receptor affinity. During this experimental period serious cardiac cell alterations take place and functional consequences will be detected in the chronic phase.

Isometric developed tension and histopathology of myocardium of chagasic mice. II.

In a preceding paper we reported the evolution of chagasic cardiopathy in mice inoculated with low number of T. cruzi from 2 days to 75 days post-infection (p.i.). The present work analyzed the contractility, pharmacological response and histopathology of myocardium isolated from chronic chagasic mice from 90 days until 180 days. p.i. Myocardium contractile force reached values similar to controls until 165 days p.i. From this to the end contractility was significantly lower. At 90 days p.i. NE provoked negative inotropic effect or had no effect in 13% of the cases tested. The others had a reactivity to NE similar to normal ventricles. From 105 days until 180 days p.i. NE induced to a positive inotropic effect significantly lower than in normal. ACh effect was significantly smaller from 165 days to the end. Previously ACh ventricles responses were as control. The effects of dibenamine, propranolol and atropine (10-6M) on chagasic ventricles were similar to those observed in normal tissues. At 90 days p.i. the histopathology showed focalized inflammatory infiltrates. At 180 days p.i. fibers fragmentations and loss of typical striated characteristic of cardiac tissue. The abnormal pharmacological response described could be attributed to alterations in cardiac beta and muscarinic receptors probably due to a lower oxygen support. The present paper shows that during chronic Chagas' disease myocardial function and pharmacological reactivity are seriously and definitively compromised.

Isometric developed tension and histopathology of myocardium of chagasic mice. II.

In a preceding paper we reported the evolution of chagasic cardiopathy in mice inoculated with low number of T. cruzi from 2 days to 75 days post-infection (p.i.). The present work analyzed the contractility, pharmacological response and histopathology of myocardium isolated from chronic chagasic mice from 90 days until 180 days. p.i. Myocardium contractile force reached values similar to controls until 165 days p.i. From this to the end contractility was significantly lower. At 90 days p.i. NE provoked negative inotropic effect or had no effect in 13

of the cases tested. The others had a reactivity to NE similar to normal ventricles. From 105 days until 180 days p.i. NE induced to a positive inotropic effect significantly lower than in normal. ACh effect was significantly smaller from 165 days to the end. Previously ACh ventricles responses were as control. The effects of dibenamine, propranolol and atropine (10-6M) on chagasic ventricles were similar to those observed in normal tissues. At 90 days p.i. the histopathology showed focalized inflammatory infiltrates. At 180 days p.i. fibers fragmentations and loss of typical striated characteristic of cardiac tissue. The abnormal pharmacological response described could be attributed to alterations in cardiac beta and muscarinic receptors probably due to a lower oxygen support. The present paper shows that during chronic Chagas disease myocardial function and pharmacological reactivity are seriously and definitively compromised.

Isometric developed tension and histopathology of myocardium of chagasic mice. II.

In a preceding paper we reported the evolution of chagasic cardiopathy in mice inoculated with low number of T. cruzi from 2 days to 75 days post-infection (p.i.). The present work analyzed the contractility, pharmacological response and histopathology of myocardium isolated from chronic chagasic mice from 90 days until 180 days. p.i. Myocardium contractile force reached values similar to controls until 165 days p.i. From this to the end contractility was significantly lower. At 90 days p.i. NE provoked negative inotropic effect or had no effect in 13

of the cases tested. The others had a reactivity to NE similar to normal ventricles. From 105 days until 180 days p.i. NE induced to a positive inotropic effect significantly lower than in normal. ACh effect was significantly smaller from 165 days to the end. Previously ACh ventricles responses were as control. The effects of dibenamine, propranolol and atropine (10-6M) on chagasic ventricles were similar to those observed in normal tissues. At 90 days p.i. the histopathology showed focalized inflammatory infiltrates. At 180 days p.i. fibers fragmentations and loss of typical striated characteristic of cardiac tissue. The abnormal pharmacological response described could be attributed to alterations in cardiac beta and muscarinic receptors probably due to a lower oxygen support. The present paper shows that during chronic Chagas disease myocardial function and pharmacological reactivity are seriously and definitively compromised.

Isometric developed tension and histopathology of myocardium of chagasic mice. I.

Cardiac disease is usually the most serious complication of human infection with Trypanosoma cruzi in our country. This report studies the evolution of the chagasic cardiopathy in mice inoculated with low number of parasites during acute and indeterminate stages in different aspects: contractility, histopathology and pharmacological response. From 2-45 days post infection (p.i.) (acute stage) myocardium contractile force reached higher values than in controls, but norepinephrine (NE) response was significantly lower. Acetylcholine (ACh) caused a negative inotropic effect similar to the observed in control group. In this period cardiac damage evolved to an acute interstitial myocarditis. In the indeterminate phase (45-75 days p.i.) of this parasitosis NE produced either small inotropic effect, negative inotropic effect or had no effect on the ventricles tested. A significantly low ACh effect, sub-endocardiac perivascular fibrosis and necrosis in wall bases were also observed. The abnormal pharmacological response described could be ascribed to modifications in cardiac beta and muscarinic receptors number or affinity. The present results showed that in myocardium isolated from T. cruzi infected mice the histopathology, contractility and pharmacological response were altered from 48 h p.i. reaching a maximum disorder at 60 days p.i.

Isometric developed tension and histopathology of myocardium of chagasic mice. I.

Cardiac disease is usually the most serious complication of human infection with Trypanosoma cruzi in our country. This report studies the evolution of the chagasic cardiopathy in mice inoculated with low number of parasites during acute and indeterminate stages in different aspects: contractility, histopathology and pharmacological response. From 2-45 days post infection (p.i.) (acute stage) myocardium contractile force reached higher values than in controls, but norepinephrine (NE) response was significantly lower. Acetylcholine (ACh) caused a negative inotropic effect similar to the observed in control group. In this period cardiac damage evolved to an acute interstitial myocarditis. In the indeterminate phase (45-75 days p.i.) of this parasitosis NE produced either small inotropic effect, negative inotropic effect or had no effect on the ventricles tested. A significantly low ACh effect, sub-endocardiac perivascular fibrosis and necrosis in wall bases were also observed. The abnormal pharmacological response described could be ascribed to modifications in cardiac beta and muscarinic receptors number or affinity. The present results showed that in myocardium isolated from T. cruzi infected mice the histopathology, contractility and pharmacological response were altered from 48 h p.i. reaching a maximum disorder at 60 days p.i.

Isometric developed tension and histopathology of myocardium of chagasic mice. I.

Cardiac disease is usually the most serious complication of human infection with Trypanosoma cruzi in our country. This report studies the evolution of the chagasic cardiopathy in mice inoculated with low number of parasites during acute and indeterminate stages in different aspects: contractility, histopathology and pharmacological response. From 2-45 days post infection (p.i.) (acute stage) myocardium contractile force reached higher values than in controls, but norepinephrine (NE) response was significantly lower. Acetylcholine (ACh) caused a negative inotropic effect similar to the observed in control group. In this period cardiac damage evolved to an acute interstitial myocarditis. In the indeterminate phase (45-75 days p.i.) of this parasitosis NE produced either small inotropic effect, negative inotropic effect or had no effect on the ventricles tested. A significantly low ACh effect, sub-endocardiac perivascular fibrosis and necrosis in wall bases were also observed. The abnormal pharmacological response described could be ascribed to modifications in cardiac beta and muscarinic receptors number or affinity. The present results showed that in myocardium isolated from T. cruzi infected mice the histopathology, contractility and pharmacological response were altered from 48 h p.i. reaching a maximum disorder at 60 days p.i.

Short communication: placental collagen and premature rupture of fetal membranes.

Collagen content of 43 placentae from clinically normal females who went into labour spontaneously was determined by assaying hydroxyproline. In 23 cases the membranes ruptured before or at the beginning of labour, and in 20 cases the rupture was intrumentally provoked during the expulsive period. In the group with prematurely ruptured membranes, hydroxyproline concentration was 11.52 +/- 1.83 micrograms/mg lyophilized tissue, whereas in the other group concentration was 20.29 +/- 4.32 micrograms/mg tissue. These data disclose a much lower collagen placental content in the group with premature rupturing of the membranes.

[Arterial hypertension in childhood and adolescence]. / Hipertension arterial en la niñez y en la adolescencia.

One thousand six hundred and ninety-eight children and adolescents four to eighteen years-old were studied, eight hundred and forty of them were males and eight hundred and fifty-eight females. No individual following, was performed. Two determinations of both systolic and diastolic pressure were registered after a fifteen minutes rest, and the average figures of both, of them was registered. The group analyzed belonged to upper middle class and the hypertension figures were: females 28 (3.26%) and males 30 (3.57%). The influence of bodily area was observed en hypertensive patients. Those located between the average +/- two standard deviations were considered as normal. (95% of the cases).

Hipertension arterial en la niñez y en la adolescencia. / [Arterial hypertension in childhood and adolescence]

One thousand six hundred and ninety-eight children and adolescents four to eighteen years-old were studied, eight hundred and forty of them were males and eight hundred and fifty-eight females. No individual following, was performed. Two determinations of both systolic and diastolic pressure were registered after a fifteen minutes rest, and the average figures of both, of them was registered. The group analyzed belonged to upper middle class and the hypertension figures were: females 28 (3.26

) and males 30 (3.57

). The influence of bodily area was observed en hypertensive patients. Those located between the average +/- two standard deviations were considered as normal. (95

of the cases).