The purpose of this study was to determine the effect of respiratory muscle fatigue on intercostal and forearm muscle perfusion and oxygenation in patients with heart failure. Five clinically stable heart failure patients with respiratory muscle weakness (age, 66±12 years; left ventricle ejection fraction, 34±3%) and nine matched healthy controls underwent a respiratory muscle fatigue protocol, breathing against a fixed resistance at 60% of their maximal inspiratory pressure for as long as they could sustain the predetermined inspiratory pressure. Intercostal and forearm muscle blood volume and oxygenation were continuously monitored by near-infrared spectroscopy with transducers placed on the seventh left intercostal space and the left forearm. Data were compared by two-way ANOVA and Bonferroni correction. Respiratory fatigue occurred at 5.1±1.3 min in heart failure patients and at 9.3±1.4 min in controls (P<0.05), but perceived effort, changes in heart rate, and in systolic blood pressure were similar between groups (P>0.05). Respiratory fatigue in heart failure reduced intercostal and forearm muscle blood volume (P<0.05) along with decreased tissue oxygenation both in intercostal (heart failure, -2.6±1.6%; controls, +1.6±0.5%; P<0.05) and in forearm muscles (heart failure, -4.5±0.5%; controls, +0.5±0.8%; P<0.05). These results suggest that respiratory fatigue in patients with heart failure causes an oxygen demand/delivery mismatch in respiratory muscles, probably leading to a reflex reduction in peripheral limb muscle perfusion, featuring a respiratory metaboreflex.

RESUMO Escherichia coli pode causar doenças em humanos e animais, tais como infecções do trato urinário, septicemia, meningites e gastroenterites. Cães assintomáticos podem participar da cadeia epidemiológica como reservatório de E. coli patogênica ao homem. Este estudo objetivou avaliar a ocorrência de E. coli patogênica ao homem em fezes de cães errantes sem sintomas de colibacilose e assim averiguar a participação do cão como fonte de infecção de colibacilose humana. Foram coletadas 220 amostras de fezes de animais capturados por diferentes Centros de Controle de Zoonoses do Estado de São Paulo. As amostras foram submetidas a exames microbiológicos sendo isoladas 196 (89,09%) estirpes de E. coli, cujos genes de fatores de virulência foram detectados por PCR. Cento e vinte e três (62,75%) estirpes apresentaram um ou mais dos fatores de virulência estudados. Dezesseis (8,16%) foram positivas para afa, 54 (27,55%) para sfa, 38 (19,38%) para pap, 66 (33,67%) para aer, 31 (15,81%) para cnf, 13 (6,63%) para hly, 1 (0,51%) para VT2 e nenhuma das linhagens foi positiva para LT, STa e STb. Cães errantes aparentemente sadios podem participar da cadeia epidemiológica como reservatórios de E. coli uropatogênica ao homem, pois os genes encontrados com maior freqüência estão presentes em infecções extraintestinais urinárias.

ABSTRACT Escherichia coli may cause diseases in humans and animals, such as urinary infections, septicemia, meningitis and gastroenteritis. Asymptomatic dogs can participate in the epidemiologic chain as a reservoir of human pathogenic E. coli. The objective of the present study was to evaluate the occurrence of pathogenic E. coli in humans, on faeces of stray dogs without colibacillosis symptoms, and thus verify the participation of dogs as a source of human colibacillosis infection. Two hundred and twenty samples of faeces from animals captured by different Zoonotic Control Centers in São Paulo state, Brazil, were collected. These faeces, when submitted to microbiological exams, resulted in the isolation of 196 (80.09%) strains of E. coli, whose virulence genes were detected by PCR. At least one of the virulence factors studied was present in 123 (62.75%) strains. Sixteen (8.16%) were afa positive, 54 (27.55%) were positive to sta, 38 (19.38%) to pap, 66 (33.67%) to aer, 31 (15.81%) to cnf, 13 (6.63%) to hly, 1 (0.51%) to VT2, and none of the strains were positive for LT, STa or STb. Stray dogs which were apparently healthy could be participating in the epidemiologic chain as an E. coli reservoir uropathogenic to man, as the genes found in a higher frequency are present in extraintestinal infections, or more specifically, urinary infections.

Caracterizaram-se a linhagem e o grau de diferenciação das células neoplásicas no estudo histopatológico e ultraestrutural da leucose mielóide. Histologicamente as células neoplásicas apresentaram pleomorfismo, núcleos ovais, nucléolos proeminentes, cromatina distribuída de maneira irregular, figuras de mitose atípicas e moderada quantidade de citoplasma contendo granulações eosinofílicas esféricas. Essas características indicam a linhagem mielóide. Ultraestruturalmente evidenciaram-se células com núcleo oval, volumoso, eletrodenso, com predomínio de eucromatina e citoplasma com numerosos grânulos esféricos, eletrodensos e homogêneos, indicando mielócitos com diferenciação para eosinófilos. Constatou-se também a presença de partículas virais tipo-C no espaço intercelular dos túbulos renais, no interior de vesículas intracitoplasmáticas dos mielócitos imaturos presentes na medula óssea e ovário, e PCR positivo para ALV-J.

An ultrastructural and histological study was performed to determine the degree of differentiation of the neoplastic cells. The histological study revealed neoplastic cells with pleomorphism, oval nuclei, prominent nucleoli, irregularly distributed chromatin, atypical mitotic figures and moderate amount of cytoplasm containing spherical eosinophilic granulations, typical features of the myeloid lineage. Ultrastructurally, there were cells with an electron-dense, oval and voluminous nucleus, with predominant euchromatin and cytoplasm containing many spherical, electron-dense and homogeneous granules, indicative of myelocytes with differentiation to eosinophils. Type-C viral particles were also seen in the intercellular space of renal tubules and inside the intracytoplasmic vesicles of immature myelocytes in the bone marrow and ovary. PCR was positive to ALV-J.