RESUMO A esclerose múltipla (EM) é a doença desmielinizante mais comum do sistema nervoso central. A cognição não é rotineiramente avaliada nos pacientes apesar da ocorrência frequente de queixas ou disfunção cognitivas. Objetivo: Comparar o perfil de pacientes com EM com controles pareados por idade, sexo e escolaridade e investigar a potencial influência de parâmetros clínicos na cognição. Métodos: Trinta e cinco pacientes com EM (idade média±desvio padrão [DP] 37,9 anos±11,44, H/M: 12/23) e 33 controles saudáveis (idade média±DP 38,8 anos±12,6, H/M: 12/21) foram incluídos neste estudo. Todos os participantes passaram por avaliação clínica estruturada e por testagem cognitiva com os seguintes instrumentos: Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modalities Test (SDMT), Rey Auditory Verbal Learning Test (RAVLT), Digit Span e testes de fluências verbais (letras F, A e S e categoria-animais). A psicopatologia foi investigada com a Mini International Neuropsychiatric Interview e com o Beck Depression Inventory (BDI). A Expanded Disability Status Scale (EDSS) foi aplicada nos pacientes. Resultados: Pacientes tiveram desempenho pior que os controles na maioria dos testes — 70% deles tiveram déficit cognitivo. A função cognitiva mais frequentemente afetada foi memória episódica (45,7%), seguida por fluência verbal (42,8%) e velocidade de processamento (22,8%). A pontuação no SDMT correlacionou-se inversamente com a gravidade da doença, medida pela EDSS. A depressão não influenciou o desempenho cognitivo nesta série de pacientes. Conclusões: Declínio cognitivo é comum em pacientes com EM. Enquanto o déficit motor se associou com a velocidade de processamento, a depressão não influenciou o desempenho cognitivo.

ABSTRACT Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system. Cognition is not routinely assessed in patients with MS though they frequently have cognitive complaints or dysfunction. Objective: The aim of this study was to compare the cognitive status of patients with MS with age, sex, and schooling matched controls and to evaluate the potential influence of clinical parameters on cognition. Methods: A total of 35 patients with MS (mean±SD age 37.9 years±11.44, M/F: 12/23) and 33 healthy controls (mean±SD age 38.8 years±12.6, M/F: 12/21) were enrolled in this study. All subjects underwent a structured clinical assessment and the cognitive tools are as follows: Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modalities Test (SDMT), Rey Auditory Verbal Learning Test (RAVLT), Digit Span, and Verbal Fluency Tests (letters F, A, and S and animal category). Psychopathology was assessed with the Mini International Neuropsychiatric Interview and the Beck Depression Inventory (BDI). The Expanded Disability Status Scale (EDSS) was used for patients. Results: Patients performed worse than controls in almost all tests, with approximately 70% of patients presenting cognitive impairment. The most affected cognitive domain was episodic memory (45.7%), followed by verbal fluency (42.8%) and information processing speed (22.8%). SDMT was inversely correlated with disease severity, as assessed by the EDSS. Depression did not influence cognitive performance in this cohort. Conclusions: Cognitive dysfunction is common among patients with MS. While motor impairment was associated with information processing speed, depression did not influence cognitive performance.

ABSTRACT. We investigated aggregation patterns in three fruit fly species economically important in Brazil, namely Ceratitis capitata, Anastrepha fraterculus, and A. obliqua. The study was carried out in a buffer zone and two neighbourhoods by comparing two-time series associated with the management strategy of fruit flies (systems approach). The abundance of these three species significantly decreased over the years with a negative binomial regression model describing the relationship between abundance and time in the entire area, buffer zone, and their neighbourhoods. In addition, the negative binomial model was also well fitted to the frequency distribution data of fruit flies in all analyzed scenarios. Anastrepha obliqua showed the highest aggregation degree, considering both the entire area and time series. A. fraterculus exhibited the lowest aggregation level, and C. capitata showed an intermediate degree. The buffer zone exhibited the highest aggregation degree for all species, and neighbourhood 2 exhibited the lowest aggregation degree. The aggregation degree was higher in the time series impacted by the systems approach than the series in the first years of its implementation.

Resumo O corretivo de acidez mais comumente utilizado nos solos tropicais é o calcário, porém a escória de aciaria pode ser alternativa para áreas de produção de grama, devido à presença do silício que pode aumentar a tolerância da grama a estresses bióticos e/ou abióticos. Este estudo foi desenvolvido para avaliar o efeito da aplicação de escória de aciaria, comparado ao calcário, na implantação de um sistema de produção de grama bermuda. O experimento foi instalado em Botucatu-SP e o delineamento experimental utilizado foi em blocos ao acaso em fatorial 2 x 5 com 4 repetições. Os tratamentos foram compostos por dois corretivos (escória de aciaria e calcário) e doses dos corretivos calculados para elevar as saturações por bases do solo para 12% (atual), 30%, 50%, 70% e 90%. A aplicação de doses de calcário e de escória de aciaria proporcionaram efeitos positivos nos atributos químicos do solo relacionados com a correção da acidez, como o pH, teores de Ca e Mg, H+Al, Al, CTC, SB, e V%. A escória proporcionou maiores teores de P, Ca e Si, enquanto o calcário maior teor de Mg no solo. A escória de aciaria proporcionou uma maior taxa de cobertura do solo pela grama bermuda quando comparado ao calcário, aos 114 e 161 DAT (dias após o transplantio), sendo a máxima taxa de cobertura obtida com a saturação por bases de 60% aos 161 DAT. As gramas que receberam a escória apresentaram maior quantidade de raízes, rizomas e estolões, quando comparados ao calcário. Sugere-se o uso da escoria de siderurgia, e, no cálculo da necessidade de corretivo, a saturação por bases do solo de 90%.

Abstract Limestone is the most commonly used acidity-correction agent in tropical soils. However, steel slag can be an alternative for turfgrass production areas because it contains silicon, which can increase turfgrass tolerance to biotic and/or abiotic stresses. This study was developed to evaluate the effect of the application of steel slag, as compared with limestone, on a bermudagrass sod production system. The experiment was carried out in Botucatu-SP, Brazil, in a randomized block design arranged in a factorial scheme 2 × 5 with 4 replications. Treatments consisted of two correctives (steel slag and limestone) and their rates, which were calculated to raise the soil base saturation to 12% (current), 30%, 50%, 70% and 90%. The application of lime and steel slag rates had positive effects on soil chemical attributes related to acidity correction, such as pH, Ca, Mg, H + Al, Al, CEC, SB, and base saturation (%). The slag provided higher levels of P, Ca, and Si, whereas limestone increased the Mg soil content. Steel slag provided a higher ground cover rate for bermudagrass than limestone at 114 and 161 days after transplanting (DAT), with maximum cover rate achieved with 60% base saturation at 161 DAT. The turfgrasses treated with slag showed a higher amount of roots, rhizomes, and stolons when compared with those treated with limestone. It is suggested the use of steel slag and, in calculating the need for corrective, 90% soil base saturation.

ABSTRACT: Nitrogen fertilization and an appropriate cutting thickness can result in firmer sod that can be handled in less time with greater turfgrass regrowth during the subsequent cycle. This experiment was conducted on a sod production farm located in Capela do Alto, in the state of Sao Paulo, Brazil. The soil was a dystrophic Rhodic Hapludox (Oxisol) with a medium texture. The experiment had two statistical designs; the initial design was randomized blocks with seven treatments and four replicates. Treatments were five doses of liquid organo-mineral fertilizer (OMF) corresponding to 0, 100, 200, 300 and 400 kg ha−1 of nitrogen (N) with supplementation of phosphorous (P) and potassium (K) as well as two control treatments - one with 300 kg ha–1 of N as OMF and the other with 300 kg ha−1 of N-urea + P and K. At harvest, the adopted design was a split-plot type with four replicates in a 7 × 3 factorial arrangement with seven treatments as the main plot and three sod cutting heights (9, 16 and 22 mm) as subplots. Nitrogen doses in the form of OMF influenced the percentage of ground cover (PGC) by turfgrass in both cycles. The N dose of 300 kg ha−1 formed the sod more quickly and provided the largest mass of roots and stolons and the highest sod tensile strength. The thinnest sod samples had faster regrowth and provided higher PGCs.

Resumo Justificativa: O delírio pós-operatório é uma complicação séria em pacientes submetidos à cirurgia abdominal de grande porte. Ainda não está claro se as variáveis hemodinâmicas e de perfusão no período perioperatório afetam o risco de delírio pós-operatório. O objetivo deste estudo piloto foi avaliar a associação entre perfusão e hemodinâmica no perioperatório com o surgimento de delírio pós-operatório. Métodos: Estudo prospectivo de coorte de adultos com 60 anos ou mais, submetidos à cirurgia eletiva aberta do cólon. As variáveis multimodais de hemodinâmica e perfusão foram monitoradas, inclusive oxigenação venosa central (ScvO2), níveis de lactato e oxigenação cerebral não invasiva (rSO2), de acordo com um protocolo-padrão de anestesia. O teste exato de Fisher ou o teste t de Student foram usados para comparar os pacientes que desenvolveram delírio pós-operatório com aqueles que não desenvolveram p < 0,05. Resultados: Avaliamos 28 pacientes, 73 ± 7 anos, 60,7% do sexo feminino. Dois pacientes desenvolveram delírio pós-operatório (7,1%). Esses dois pacientes tinham menos anos de escolaridade do que aqueles sem delírio pós-operatório (p = 0,031). Nenhuma das variáveis de pressão arterial no perioperatório foi associada à incidência de delírio. Quanto aos parâmetros de perfusão, ScvO2 foi menor no grupo que apresentou delírio pós-operatório do que no grupo que não apresentou delírio, sem atingir significância estatística (65 ± 10% vs. 74 ± 5%; p = 0,08), mas o delta-ScvO2 (a diferença entre as médias no pós-operatório e intraoperatório) foi associado ao delírio (p = 0,043). As variáveis de lactato e rSO2 no pós-operatório não foram associadas ao delírio. Conclusões: Nosso estudo piloto sugere uma associação entre delta-ScvO2 e delírio e uma tendência à diminuição da ScvO2 no pós-operatório de pacientes com delírio. Estudos adicionais são necessários para elucidar essa associação.

Abstract Background: Post-operative delirium is a serious complication in patients undergoing major abdominal surgery. It remains unclear whether peri-operative hemodynamic and perfusion variables affect the risk for postoperative delirium. The objective of this pilot study was to evaluate the association between perfusion and hemodynamics peri-operative with the appearance of post-operative delirium. Methods: Prospective cohort study of adults 60 years or older undergoing elective open colon surgery. Multimodal hemodynamic and perfusion variables were monitored, including central venous oxygenation (ScvO2), lactate levels, and non-invasive cerebral oxygenation (rSO2), according to a standard anesthesia protocol. Fisher's exact test or Student's t-test were used to compare patients who developed post-operative delirium with those who did not (p < 0.05). Results: We studied 28 patients, age 73 ± 7 years, 60.7% female. Two patients developed post-operative delirium (7.1%). These two patients had fewer years of education than those without delirium (p = 0.031). None of the peri-operative blood pressure variables were associated with incidence of post-operative delirium. In terms of perfusion parameters, postoperative ScvO2 was lower in the delirium than the non-delirium group, without reaching statistical significance (65 ± 10% vs. 74 ± 5%; p = 0.08), but the delta-ScvO2 (the difference between means post-operative and intra-operative) was associated with post-operative delirium (p = 0.043). Post-operative lactate and rSO2 variables were not associated with delirium. Conclusions: Our pilot study suggests an association between delta ScvO2 and post-operative delirium, and a tendency to lower post-operative ScvO2 in patients who developed delirium. Further studies are necessary to elucidate this association.

Abstract Objective: The present study refers to a determination of the preoperative B-type natriuretic peptide is a predictor of short-term all-cause mortality in patients undergoing on-pump coronary artery bypass graft surgeries. Methods: Two hundred and twenty-one patients undergoing on-pump coronary artery bypass graft surgeries were evaluated prospectively during a 30-day postoperative follow-up period. Serum B-type natriuretic peptide concentration was measured without a 24-hour period prior to the surgical procedure and the value obtained was correlated with a short-term all-cause mortality. Results: Data analysis showed that all-cause mortality rates were equal to 9.5% in 30 days. Accuracy analysis by the receiver operating characteristic curve found an ideal cut-off value of B-type natriuretic peptide equal to 150 pg/mL in relation to mortality (AUC=0.82, 95% CI=0.71-0.87, P<0.001). Multivariate analysis showed that B-type natriuretic peptide value greater than or equal to 150 pg/mL (P=0.030, HR=3.99, 95% CI=1.14-13.98) was an independent predictor of all-cause mortality in a 30-day follow-up period. Conclusion: Preoperative serum B-type natriuretic peptide concentration is an independent predictor of short-term all-cause mortality in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass.

RESUMO Objetivo Avaliar a prevalência e o risco de suicídio em uma amostra brasileira de pacientes com esclerose múltipla (MS) e identificar fatores potenciais associados ao risco de suicídio. Foi realizado um estudo com pacientes ambulatoriais com diagnóstico de esclerose múltipla. O risco de suicídio e a presença de transtornos psiquiátricos foram avaliados pela versão 5.0 do Mini-International Neuropsychiatric Interview (MINI). A amostra de pacientes em risco de suicídio foi pareada por sexo e idade a um grupo-controle de pacientes com MS. Resultados Dos pacientes, 8,3% tinham antecedentes de tentativa de suicídio e 8,3% tinham risco de suicídio atual, totalizando 16,6%. Os resultados encontrados neste estudo sugerem que os fatores de risco associados ao suicídio nessa população são: depressão, estado civil solteiro, viúvo ou divorciado e nível de escolaridade mais baixo.

ABSTRACT Objective To evaluated the prevalence and the suicide risk in a Brazilian sample of patients with multiple sclerosis (MS) and to identify potential factors associated with the risk of suicide. A study was performed with outpatient with MS. The risk of suicide and the presence of psychiatric disorders were assessed by version 5.0 of the Mini-International Neuropsychiatric Interview (MINI). The sample of patients at risk for suicide was matched by sex and age to a control group of patients with MS. Results Eight point three percent of the patients had a past history of attempted suicide, and 8.3% had a current suicide risk, totaling 16.6%. The results of this study suggest that the risk factors associated with suicide in this population are depression, marital status single, widowed or divorced, and lower education level.

The aim of this study was to assess the early colonization of four periodontopathogenic bacteria (A. actinomycetemcomitans, P. gingivalis, T. forsythensis and T. denticola) on titanium implants immediately after two weeks following second stage surgery; to compare the presence of these four periodontopathogenic bacteria at subgingival implant and adjacent tooth sites. Subgingival plaque samples from implant and neighboring teeth were studied by PCR after two weeks following second stage surgery. Sixteen implants and thirteen teeth, in ten patients were selected. At two weeks, pathogenic bacteria presence was found in both peri-implant and periodontal sites, there was no relation found between tooth and implant for P. gingivalis, T. forsythensis and T. denticola. A significant relation was found for A. actinomycetemcomitans (P<0.005). The more frequently detected bacteria were P. gingivalis, and the less was T. denticola. The dependence for A. actinomycetemcomitans was related to patients with a history of periodontitis. Within the limits of this study, the findings showed the early presence of the four periodontopathogenic bacteria around implant sites and a statistically significant (P<0.005) relation between implants and teeth sites for A. actinomycetemcomitans.

El objetivo de este trabajo fue valuar la presencia temprana en sitios dentarios e implantarios de cuatro bacterias periodontopatógenas (A. actinomycetemcomitans, P. gingivalis, T. forsythensis y T. denticola) luego de dos semanas de la cirugía de segunda fase, además se propone comparar la presencia de estas 4 bacterias en sitios subgingivales dentarios e implantarios. Se estudiaron mediante reacción en cadena de polimerasa muestras de placa subgingival de implantes y de dientes vecinos a ellos, dos semanas luego de la cirugía de segunda fase. Dieciséis implantes y trece dientes en diez pacientes fueron seleccionados. Luego de dos semanas se encontró presencia de bacterias periodontopatógenas en sitios tanto periodontales como peri-implantarios, no se encontró relación entre diente e implante para P. gingivalis, T. forsythensis y T. denticola. Se encontró una relación significativa para A. actinomycetemcomitans (P<0,005). La bacteria detectada con mayor frecuencia fue P. gingivalis y la menos encontrada fue T. denticola. La dependencia para A. actinomycetemcomitans estuvo relacionada a pacientes con historia de periodontitis. Dentro de los límites de este estudio, los resultados muestran la presencia temprana de los cuatro patógenos periodontales alrededor de los sitios implantarios, y una relación estadísticamente significativa (P<0,005) entre implante y diente para A. actinomycetemcomitans.

A eficiência da adubação nitrogenada para gramados pode ser aumentada com a utilização de fontes de liberação lenta, como composto de lodo de esgoto, que, em razão das suas características, pode ser um substituto de parte ou do total da adubação inorgânica para as gramas. Não foram encontrados resultados referentes à utilização de lodo compostado na cultura da grama, no Brasil. Objetivou-se com este trabalho avaliar o efeito de doses de composto de lodo de esgoto na produção da grama esmeralda Imperial. Os tratamentos foram constituídos de cinco doses de composto de lodo de esgoto (0, 12, 24, 36 e 48 Mg ha-1, base seca), mais um tratamento com adubação inorgânica (300 kg ha-1 N, 80 kg ha-1 P2O5 e 200 kg ha-1 K2O). Os compostos orgânicos presentes no composto têm diferentes taxas de mineralização, liberando aos 120 dias após a aplicação do lodo mais Mg (100 %), K (90 %) e N (67 %) do que S (57 %), P (40 %) e Ca (31 %). A utilização do composto de lodo na cultura da grama Imperial proporcionou adequado fornecimento de nutrientes, quando aplicado superficialmente, em doses maiores que 36 Mg ha-1. As doses de composto proporcionaram, após a colheita do tapete, aumento linear da acidez potencial e do teor de matéria orgânica, P, S, Fe, Cu, Mn, Zn, As, Cu e Ni e redução linear do pH, do teor de Ca e Mg e da saturação por bases do solo. O aumento das doses do composto de 0 a 48 Mg ha-1 reduziu a massa dos tapetes de grama, atingindo valores de 4,0 kg/tapete, quando a maior dose foi aplicada. Altas doses também proporcionaram os maiores valores de resistência dos tapetes na ordem de 35 e 33 kgf, com as doses de 36 e 48 Mg ha-1, respectivamente.

The efficiency of nitrogen fertilization for sod production can be increased by using slow-release sources such as sewage sludge compost, which, due to its characteristics can be a substitute of part or all inorganic fertilization for grass. No results were found for the use of sludge compost in sod production in Brazil. This study evaluated the effect of rates of sewage sludge compost on the production of zoysiagrass. Treatments consisted of five rates of composted sewage sludge compost (0, 12, 24, 36 and 48 Mg ha-1, on a dry basis), plus a treatment of inorganic fertilization (300 kg ha-1 N, 80 kg ha-1 P2O5, and 200 kg ha-1 K2O). The results indicated different mineralization rates of the organic compounds present in the sludge; 120 days after sludge application, more Mg (100 %), K (90 %) and N (67 %) has been released than S (57 %), P (40 %) and Ca (31 %). The use of composted sewage sludge for zoysiagrass adequately supplied nutrients when applied to the soil surface at rates more than 36 Mg ha-1. After sod cutting, the rates of sewage sludge compost provided a linear increase in potential soil acidity, soil contents of OM, P, S, Fe, Cu, Mn, Zn, Cu and Ni, and linear decrease in pH, soil concentration of Ca and Mg and base saturation. Compost rates, increasing from 0 to 48 Mg ha-1, reduced the sod mass, reaching values of 4.0 kg/sod at the highest rate. High compost doses (36 and 48 Mg ha-1, respectively) also induced the highest resistance, with values in the order of 35 and 33 kgf.

Abstract: Objective. To evaluate a barium study of the upper gastrointestinal tract in early postoperative monitoring of bariatric surgery patients, recording the anatomical characteristics of the gastric remnant and the frequency of complications such as leakage of contrast and emptying difficulties. Materials and Methods. We retrospectively evaluated the barium study of the upper gastrointestinal tract performed in 168 patients after gastric bypass (GBP) and 98 patients after vertical subtotal gastrectomy (VSG). All evaluated examinations were performed in the first five days after surgery. Gastric remnant volume was registered in relation to the T12 vertebral body (only in GBP), the presence and site of contrast leakage and gastric remnant emptying difficulties. Results. The average age of patients undergoing GBP was 43 years, and 37 years for VSG. The average volume of gastric remnant of patients with GBP was 1.5 T12 vertebral bodies. Two GBP operated patients (1.2%) had leakage of the contrast medium at the level of the gastroenteric anastomosis; in VSG operated patients the contrast leakage occurred in 7 cases (7.1%), the most frequent site being the left side cephalic portion of the gastric remnant. All cases with contrast leakage were subsequently studied using computed tomography, finding the presence of wound dehiscence or fluid collections adjacent to the gastric remnant. Emptying difficulty was observed in 12 patients operated for GBP (7.1%); there was no record of this complication in patients undergoing VSG. Conclusion. The upper gastrointestinal barium study is useful in patients after bariatric surgery to assess the early postoperative anatomy and volume of the gastric remnant, as well as to detect possible complications. It is a simple test, which should be applied as a routine control in these patients.

Objetivo. Evaluar el estudio baritado del tubo digestivo alto en el control postoperatorio precoz de pacientes operados de cirugía bariátrica, registrando las características anatómicas del remanente gástrico y la frecuencia de complicaciones como filtración del medio de contraste y dificultad al vaciamiento. Materiales y método. Se evaluó retrospectivamente el estudio baritado del tubo digestivo alto realizado en 168 pacientes postoperados de bypass gástrico (BPG) y 98 pacientes postoperados de gastrectomía subtotal vertical (GSV). Todos los exámenes evaluados fueron realizados en los primeros cinco días postcirugía. Se registró volumen del remanente gástrico en relación al cuerpo vertebral T12 (sólo en BPG), presencia y sitio de filtración del medio de contraste y dificultad al vaciamiento del remanente gástrico. Resultados. La edad promedio de los pacientes sometidos a BPG fue de 43 años y GSV 37 años. El volumen promedio del remanente gástrico de los pacientes con BPG fue 1,5 cuerpos vertebrales T12. Dos pacientes operados de BPG (1,2%) presentaron filtración de medio de contraste a nivel de la anastomosis gastro-enteral; en los pacientes operados de GSV la filtración del medio de contraste ocurrió en 7 casos (7,1%), siendo el sitio más frecuente la porción cefálica lateral izquierda del remanente gástrico. Todos los casos de filtración de medio de contraste fueron posteriormente estudiados con tomografía computada, comprobándose la presencia de dehiscencia de la sutura o bien colecciones líquidas adyacentes al remanente gástrico. Se observó dificultad al vaciamiento en 12 pacientes operados de BPG (7,1%); no se registró esta complicación en los pacientes operados de GSV. Conclusión. El estudio baritado del tubo digestivo alto es útil en pacientes postoperados de cirugía bariátrica para conocer la anatomía y el volumen del remanente gástrico en el postoperatorio precoz, asícomo también para detectar posibles complicaciones. Es un examen sencillo, que debiese aplicarse como control rutinario en estos pacientes.

A ecocardiografia é um método não invasivo e adequado para a avaliação das alterações cardíacas em equinos, identificando assim aqueles animais que apresentaram melhor adaptação e condicionamento ao exercício a que foram submetidos. O objetivo deste estudo foi verificar por meio de exames ecocardiográficos em modo-M e bidimensional os índices funcionais cardíacos de 15 equinos Puro Sangue Árabe, sendo nove machos e seis fêmeas, com idade variando de seis a 12 anos, submetidos a diferentes intensidades de exercício prolongado de enduro. Para tanto, foram divididos em três grupos, sendo que quatro animais percorreram 30km (GI), seis animais percorreram 90km (GII) e cinco animais percorreram 120km (GIII). As avaliações ocorreram antes do início de cada prova, sendo considerado o momento zero (M0) e 30 minutos após percorrerem o último anel da correspondente prova, caracterizando o momento final (Mf). Diante do tratamento estatístico, não se verificaram diferenças significantes entre os índices obtidos no M0 e Mf do GI. De outra forma, no GII para VS, FC, VEs e VEd, assim como no GIII para VS, FC, VEs, VEd e SIVd, observou-se diferença estatística. Portanto, em equinos de enduro a ecocardiografia revelou que o exercício físico permitiu o estabelecimento de índices funcionais cardíacos próprios, de acordo com a intensidade do exercício imposto.

Echocardiography is a noninvasive and accurate evaluation of cardiac abnormalities in horses, thereby determining those animals that show better adaptation to exercise and conditioning to which they were submitted. The aim of this study was to verify by echocardiographic M-mode and two-dimensional cardiac functional indices of 15 purebred Arabian horses, nine males and six females, ranging in age from 6 to 12 years, subjected to different intensities prolonged endurance exercise. Thus, both groups were divided into three, in which four animals traveled 30km (GI), six animals traveled 90km (GII) and five animals traveled 120km (GIII). Assessments occurred before the start of each test and was considered the time zero (M0); 30 minutes after running through the last ring of the race characterized the final moment (Mf). Before the treatment there were no statistically significant differences between the indexes obtained in the M0 and Mf of GI. Otherwise, it was observed statistical difference in GII for stroke volume, heart rate, left ventricular internal diameter in diastole and systole, and in GIII for stroke volume, heart rate, left ventricular internal diameter in diastole and systole and interventricular septal thickness in diastole. So endurance horses echocardiography revealed that the exercise enabled the assessment of cardiac functional indexes according to the intensity of the exercise tax.

OBJETIVO: Estabelecer um valor de corte para a troponina I, correlacionando-a com a ocorrência de infarto do miocárdio pós-cirúrgico (IAMPC). MÉTODOS: Foram incluídos 180 pacientes consecutivos portadores de coronariopatia obstrutiva com indicação cirúrgica. A idade média dos pacientes foi de 60,6 ± 9,3 anos, sendo 119 (66,1%) do sexo masculino e 61 (33,9%), do feminino. Os pacientes foram divididos em dois grupos: grupo sem infarto (A) - 170 pacientes - e infartado (B) - 10 pacientes. Foram coletados de cada um troponina I, ao momento da indução anestésica e ao segundo dia do pósoperatório, e correlacionada com a presença ou não de IAMPC. A análise estatística foi feita com a ajuda do programa StatsDirect 1.6.0 para Windows. RESULTADOS: A troponina I pré-operatória apresentou uma média de 1,0 ± 6 ng/ml. A regressão logística univariada mostrou correlação da troponina I do segundo dia de pós-operatório com IAMPC com P=0,0005. A curva ROC determinou um valor de corte de 6,1 ng/ml, sensibilidade = 90,0% e especificidade = 82,1%, OR = 49,8 (IC 95% 6,1-410,4) com P<0,0001. CONCLUSÃO: A chance de um paciente com infarto pósoperatório apresentar troponina igual ou superior a 6,1 ng/ml é 49,8 vezes maior do que a de um paciente que não infartou apresentar troponina acima desse nível.

OBJECTIVE: The aim of this study is to establish a cut-off value for troponin I by correlating it to occurrence of postoperative myocardial infarction. METHODS: 180 consecutive patients with coronary disease referred for surgery were included. The mean age of the patients were 60.6 (±9.3) years, with 119 (66.1%) males and 61 (33.9%) females. The patients were divided into two groups: group without myocardial infarction (A) - 170 patients - and with myocardial infarction (B) - 10 patients.The troponin I was collected from each patient at the beginning of anesthesia and on the second postoperative day by correlating it to presence or not of postoperative myocardial infarction. StatsDirect 1.6.0 for Windows was used for statistical analysis. RESULTS: Preoperative troponin I was 1.0 (±6) ng/ml as mean. Univariate logistic regression showed correlation of troponin I of the second postoperative day with myocardial infarction (P=0.0005). ROC curve was used to define the cutoff value, and 6.1 ng/ml (sensitivity=90.0%, specificity=82.1%, OR=49.8 with CI=95% 6.1- 410.4, P<0.0001) were found. CONCLUSION: The chance of a patient with postoperative myocardial infarction to present troponin I equal to or higher than 6.1 ng/ml is 49.8-fold higher than the chance of a patient without infarction to present troponin I higher than this value.

OBJETIVO: Analisar os efeitos, após 24 meses, de um programa de reabilitação pulmonar (PRP) sobre os níveis de ansiedade, depressão, qualidade de vida e desempenho físico em pacientes com DPOC. MÉTODOS: Trinta pacientes com DPOC (idade média, 60,8 ± 10 anos; 70% do sexo masculino) participaram de um PRP com 12 semanas de duração, incluindo 24 sessões de exercício físico, 24 sessões de reeducação respiratória, 12 sessões de psicoterapia e 3 sessões educacionais. Os pacientes foram avaliados na linha de base (pré-PRP), ao término do PRP (pós-PRP) e dois anos mais tarde (momento atual) através de quatro instrumentos: Inventário de Ansiedade de Beck; Inventário de Depressão de Beck; Questionário Respiratório do Hospital Saint George; e teste da caminhada de 6 minutos (TC6). RESULTADOS: A comparação entre o pré-PRP e o pós-PRP revelou uma redução significativa dos níveis de ansiedade (pré-PRP: 10,7 ± 6,3; pós-PRP: 5,5 ± 4,4; p = 0,0005) e de depressão (pré-PRP: 11,7 ± 6,8; pós-PRP: 6,0 ± 5,8; p = 0,001), assim como melhoras na distância percorrida no TC6 (pré-PRP: 428,6 ± 75,0 m; pós-PRP: 474,9 ± 86,3 m; p = 0,03) e no índice de qualidade de vida (pré-PRP: 51,0 ± 15,9; pós-PRP: 34,7 ± 15,1; p = 0,0001). Não houve diferenças estatisticamente significativas entre os resultados do pós-PRP e os do momento atual. CONCLUSÕES: Os benefícios obtidos através do PRP sobre os índices de ansiedade, depressão e qualidade de vida, assim como no TC6, persistiram ao longo dos 24 meses.

OBJECTIVE: To assess the 24-month effects of a pulmonary rehabilitation program (PRP) on anxiety, depression, quality of life and physical performance of COPD patients. METHODS: Thirty patients with COPD (mean age, 60.8 ± 10 years; 70% males) participated in a 12-week PRP, which included 24 physical exercise sessions, 24 respiratory rehabilitation sessions, 12 psychotherapy sessions and 3 educational sessions. All patients were evaluated at baseline (pre-PRP), at the end of the treatment (post-PRP) and two years later (current) by means of four instruments: the Beck Anxiety Inventory; the Beck Depression Inventory; Saint George's Respiratory Questionnaire; and the six-minute walk test (6MWT). RESULTS: The comparison between the pre-PRP and post-PRP values revealed a significant decrease in the levels of anxiety (pre-PRP: 10.7 ± 6.3; post-PRP: 5.5 ± 4.4; p = 0.0005) and depression (pre-PRP: 11.7 ± 6.8; post-PRP: 6.0 ± 5.8; p = 0.001), as well as significant improvements in the distance covered on the 6MWT (pre-PRP: 428.6 ± 75.0 m; post-PRP: 474.9 ± 86.3 m; p = 0.03) and the quality of life index (pre-PRP: 51.0 ± 15.9; post-PRP: 34.7 ± 15.1; p = 0.0001). There were no statistically significant differences between the post-PRP and current evaluation values. CONCLUSIONS: The benefits provided by the PRP in terms of the indices of anxiety, depression and quality of life, as well as the improved 6MWT performance, persisted throughout the 24-month study period.

OBJETIVO: Avaliar o efeito da psicoterapia sobre os níveis de ansiedade, depressão, qualidade de vida e capacidade de exercício em portadores de doença pulmonar obstrutiva crônica, submetidos a um programa de reabilitação pulmonar. MÉTODOS: Ensaio clínico prospectivo, controlado e cego realizado com 49 portadores de doença pulmonar obstrutiva crônica randomizados em três grupos: programa de reabilitação pulmonar completo (grupo 1), sem exercícios físicos (grupo 2) e sem psicoterapia (grupo 3). Foram utilizados para avaliação: inventários de ansiedade e de depressão de Beck, questionário respiratório de Saint George e o produto da distância caminhada pelo peso. RESULTADOS: Os grupos 1 e 2 demonstraram melhora absoluta estatisticamente significativa na capacidade de realizar exercícios (p = 0,007, p = 0,008 e p = 0,06, respectivamente). Os grupos 1 e 2 demonstraram redução significativa dos níveis de ansiedade e depressão, e melhora no índice de qualidade de vida: grupo 1 - p = 0,0000, p < 0,0003 e p = 0,0007; e grupo 2 - p = 0,0001, p = 0,0014 e p = 0,002, respectivamente. O grupo 3 demonstrou redução no nível de ansiedade (p = 0,03), mas não no nível de depressão e no índice de qualidade de vida, significativamente. CONCLUSÃO: Sessões de psicoterapia num programa de reabilitação pulmonar auxiliaram portadores de doença pulmonar obstrutiva crônica no manejo das limitações impostas pela doença, através da redução dos níveis de sintomas comportamentais, especialmente depressão, influindo na melhora da capacidade de realizar exercícios físicos e na qualidade de vida relacionada à saúde.

OBJECTIVE: To assess the effect of psychotherapy on levels of anxiety and depression, as well as on quality of life and exercise capacity in patients with chronic obstructive pulmonary disease enrolled in a pulmonary rehabilitation program. METHODS: A randomized, controlled, blind clinical trial was conducted involving 49 chronic obstructive pulmonary disease patients. Patients were randomized into three groups: those submitted to the complete pulmonary rehabilitation program, which included psychotherapy and an exercise regimen (group 1); those submitted to the program minus physical exercise (group 2); and those submitted to the program minus psychotherapy (group 3). The three groups underwent a 12-week treatment program. All patients were evaluated at baseline and at completion of the pulmonary rehabilitation program through four instruments: The Beck Anxiety Inventory, Beck Depression Inventory and St. George's Respiratory Questionnaire were applied. The distance walked-weight product was also calculated. RESULTS: Statistically significant absolute improvements in exercise capacity were found for groups 1 and 2, although not for group 3 (p = 0.007, p = 0.008 and p = 0.06, respectively). In groups 1 and 2, levels of anxiety and depressions were also significantly reduced (group 1: p = 0.0000 and p < 0.0003; group 2: p = 0.0001 and p = 0.0014), and quality of life was significantly improved (p = 0.0007 and p = 0.002, respectively). Anxiety levels were also reduced in group 3 (p = 0.03), although levels of depression were not, and quality of life was unaffected. CONCLUSION: Psychotherapy sessions provided as part of a pulmonary rehabilitation program assist patients with chronic obstructive pulmonary disease in coping with disease-related limitations by reducing behavioral symptoms, especially depression, thereby influencing exercise capacity and health-related quality of life.