Haptoglobin and its association with naturally occurring diseases in Holstein heifer calves / [Haptoglobina e sua associação com doenças ocorridas naturalmente em bezerras da raça Holandesa]

The present study evaluated the use of haptoglobin (Hp) as an indicator of health and performance in 166 Holstein heifer calves reared in an intensive production system. Calves were evaluated at D6-9; D10-13; D20-23; D35-38 and D65-68, corresponding to the days of life. The absence or presence of diseases was evaluated by physical examination and classification of scores. The performance parameters evaluated were body weight, height at withers and hind width. Hp was measured by spectrophotometric technique. The highest prevalence of diarrhea (59.4%; 98/165) was observed in D10-13, bovine respiratory disease (BRD) was on D35-38 (25.8%; 42/163), and umbilical inflammations in D6-D9 (7.8%; 13/166). Highest values of Hp were observed in animals with diarrhea (P=0.02), and umbilical inflammation (P=0.057), in comparison with the group of healthy calves. A significant negative correlation was observed between Hp and performance index. This protein presented an important relation with diarrhea and performance of the calves, opening perspectives on its utilization as a biomarker of diseases.(AU)

O presente estudo avaliou o uso da haptoglobina (Hp) como indicadora de sanidade e desempenho em 166 bezerras Holandesas criadas em um sistema de produção intensivo. As bezerras foram avaliadas nos momentos D6-9; D10-13; D20-23; D35-38 e D65-68, sendo estes correspondentes aos dias de vida. A ausência ou a presença de doenças foi avaliada por meio do exame físico e da classificação por escores. Os parâmetros de desempenho avaliados foram peso corporal, altura de cernelha e largura de garupa. A Hp foi mensurada por técnica espectrofotométrica. A maior prevalência de diarreia (59,4%; 98/165) foi observada em D10-13, doença respiratória bovina (DRB) ocorreu em D35-38 (25,8%; 42/163) e inflamações umbilicais em D6-D9 (7,8%; 13/166). O valor de Hp foi maior nos animais que apresentaram diarreia (P=0,02) e inflamações umbilicais (P=0,057), em comparação ao grupo de bezerras saudáveis. Houve correlação negativa significativa entre a Hp e os índices de desempenho. Essa proteína apresentou uma importante relação com a diarreia e com o desempenho das bezerras, abrindo perspectivas sobre a sua utilização como biomarcadora de doenças.(AU)

Impact of beta-blockers on cardiopulmonary exercise testing in patients with advanced liver disease.

BACKGROUND: Patients with advanced liver disease may develop portal hypertension that can result in variceal haemorrhage. Beta-blockers reduce portal pressure and minimise haemorrhage risk. These medications may attenuate measures of cardiopulmonary performance, such as the ventilatory threshold and peak oxygen uptake measured via cardiopulmonary exercise testing. AIM: To determine the effect of beta-blockers on cardiopulmonary exercise testing variables in patients with advanced liver disease. METHODS: This was a cross-sectional analysis of 72 participants who completed a cardiopulmonary exercise test before liver transplantation. All participants remained on their usual beta-blocker dose and timing prior to the test. Variables measured during cardiopulmonary exercise testing included the ventilatory threshold, peak oxygen uptake, heart rate, oxygen pulse, the oxygen uptake efficiency slope and the ventilatory equivalents for carbon dioxide slope. RESULTS: Participants taking beta-blockers (n = 28) had a lower ventilatory threshold (P <.01) and peak oxygen uptake (P = .02), compared to participants not taking beta-blockers. After adjusting for age, the model of end-stage liver-disease score, liver-disease aetiology, presence of refractory ascites and ventilatory threshold remained significantly lower in the beta-blocker group (P = .04). The oxygen uptake efficiency slope was not impacted by beta-blocker use. CONCLUSIONS: Ventilatory threshold is reduced in patients with advanced liver disease taking beta-blockers compared to those not taking the medication. This may incorrectly risk stratify patients on beta-blockers and has implications for patient management before and after liver transplantation. The oxygen uptake efficiency slope was not influenced by beta-blockers and may therefore be a better measure of cardiopulmonary performance in this patient population.

[Coronary revascularization with extracorporeal circulation, aortic clamping or OPCAB: does the method's choice influence the results?]. / Cirurgia coronária com circulação extra-corporal, clampagem aórtica ou OPCAB: será que a escolha do método influencia os resultados?

BACKGROUND AND OBJECTIVES: Off pump CABG-OPCAB is the most recent development in coronary surgery and is aimed to avoid the complications of extracorporeal circulation and to compete with interventional cardiology. The objective of this study is to compare 3 methods for cardiac support for CABG. METHODS: Between February 2001 and December 2002 ninety consecutive patients were operated by the same surgeon and the same team with the following techniques: extracorporeal circulation (CEC) and ischaemic arrest, CEC and beating heart, and OPCAB. RESULTS: There were no difference in mortality and morbidity for the 3 groups of patients. The OPCAB group showed less ventilation time, less blood transfusion needs and shorter hospital stays than the other 2 groups of patients that showed no differences between each other. CONCLUSION: OPCAB is safe and showed slight advantage over CEC supported groups but the number of grafts per patient was smaller.

Pathological exon skipping in an HNPCC proband with MLH1 splice acceptor site mutation.

One of the most commonly mutated mismatch repair genes in human nonpolyposis colorectal cancer (HNPCC) is MLH1. We identified a splice site mutation in MLH1 in a colorectal cancer proband (T-to-A at position -11 of intron 1 splice acceptor) and investigated its functional consequences by RT-PCR, using lymphocyte mRNA from the proband, two noncarrying siblings, and one unrelated individual. Subcloning of PCR products followed by sequencing of individual clones revealed increased transcript heterogeneity in the mutation carrier, attributable to the presence of a variety of mRNA forms lacking exon 2, or combinations of exons 2, 4, 6, 9, and 10. The full-length transcript subcloned from the mutation carrier was detected with a much reduced frequency, suggesting that only the wild-type allele produced functional MLH1 mRNA. The three noncarriers expressed some previously described transcripts and several novel variants, but none that lacked exon 2. The results are consistent with the hypothesis that this splice site mutation causes skipping of MLH1 exon 2 in a large proportion of mRNA transcripts derived from the mutated allele. Such an observation strengthens the case for identifying the mutation as pathogenic in this HNPCC family, which is of interest given the rarity of exon skipping defects resulting from splice acceptor site mutations outside the invariant AG dinucleotide.

[The use of Abciximab in patients with acute myocardial infarction undergoing direct percutaneous coronary revascularization]. / Utilização de Abciximab em doentes com enfarte agudo do miocárdio submetidos a angioplastia coronária directa.

OBJECTIVE: To evaluate the initial experience, in our Centre, with Abciximab in patients with acute myocardial infarction undergoing direct percutaneous transluminal coronary angioplasty (PTCA). METHODS: Between October 1996 and May 1998, 65 patients (51 males, mean age 56.9 +/- 11 years) underwent direct PTCA for acute myocardial infarction. In thirty-seven patients the myocardial infarction was anterior and 40 had multivessels disease. Mainly to compare the incidence of bleeding complications we considered 2 groups: Group A--17 patients submitted to PTCA without the use of Abciximab, and Group B--48 patients submitted to PTCA and to a bolus followed by a 12 hour infusion of Abciximab. All the patients were treated with aspirin and heparin (5,000 to 15,000 U according to ACT) and ticlopidine in case of stent implantation. RESULTS: Percutaneous coronary revascularization was successfully achieved in 92.3% of the patients. The total number of bleeding complications was ten cases (20.8%) in Group B and 1 case (5.8%) in Group A. Most of the bleeding complications in the Abciximab Group were minor and related to the femoral vascular access site (9 cases--18.7%) and were easily resolved with local measures (8 cases). There were also 3 cases of hematemesis and one of oral bleeding, all well tolerated. Major bleeding complications were identified in only one patient of the Abciximab Group related to the vascular access site, however there was an absolutely similar case in Group A (2% versus 5.8%). CONCLUSIONS: Although bleeding complications were more frequent in patients receiving Abciximab, mostly related to the vascular access site, they were transient and well tolerated.

[Mitral prostheses with and without dysfunction: evaluation using 2-D Doppler echocardiography]. / Próteses mitrais com e sem disfunção: avaliação por ecocardiografia 2-D Doppler.

STUDY OBJECTIVE: To evaluate the flow characteristics of normal and abnormal functioning mechanical and bioprosthetic (B) mitral valves. DESIGN: Prospective study in patients submitted to mitral valve replacement. SETTING: Laboratory of Echocardiography at Santa Marta Hospital. PATIENTS: 61 consecutive and asymptomatic patients with normally functioning mitral prosthesis (prt)--37 Bjork-Shiley (B-S), 11 Carpentier-Edwards (C-E), 5 Hancok (HAN), 7 Ionescu-Shiley (I-S) and 1 Wessex--and 15 pts with abnormal prosthetic function (6 B-S, 5 Hall-Kaster, 2 C-E, 1 I-S and 1 HAN). INTERVENTION: Prosthetic mitral flow record, using 2D-Doppler echocardiography, to analyse: peak velocity (PV), peak gradient (PG), mean gradient (MG), pressure half time (PHT), area (A) and presence of regurgitation (R). RESULTS: Normally functioning prosthetic valves--PV ranged from 88 to 186 cm/s (134.6 +/- 24.3) in B-S prt and 133 to 198 cm/s (157.4 +/- 18.8) in B, p less than 0.0001. The prt B-S showed a greater PG (10.3 +/- 2.5 vs 7.6 +/- 2.6 mmHg), MG (3.1 +/- 1.1 vs 2.6 +/- 1 mmHg) and smaller area (2.3 +/- 0.4 vs 2.5 +/- 0.4 cm2) then Bioprosthetic ones, p less than 0.0001, p = 0.003, p = 0.003 respectively. There was a significant correlation between PG and MG: r = 0.84, r = 0.87, r = 0.84 respectively in B-S prt, Bioprosthesis and both, p less than 0.001. Mild regurgitation was present in 8 pts with prt B-S and 4 with B. Malfunctioning prosthetic valves--The mean of PV was 238.5 +/- 29.2 cm/s in prt B-S compared to 265.48.2 +/- 48.2 cm/s in B. Significant regurgitation, was detected by Doppler technic in 100% of B and 72% of mechanical prt. PV greater than 2 m/s has a 100% sensitivity and specificity to separate normal from abnormal prosthesis function. CONCLUSIONS: These data may be useful as reference values to the follow-up of pts with these types of prt. The prt B-S seems to have more optimal hemodynamics profile than B ones. Protodiastolic transprosthetic PV greater than 2 m/s suggest abnormal functioning valve. PG is a significant determinant of MG.