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Professor Dr. José Manuel Rivero Carvallo: a universal and Mexican giant of cardiovascular semiology
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Pérez-Riera, Andrés R.

; Barbosa-Barros, Raimundo

; Silva-Rocha, Maurício da

; Daminello-Raimundo, Rodrigo

; Carlos-de-Abreu, Luiz

; Nikus, Kjell

Archivos de cardiología de México

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jun 2023, Volume 93 N. 2 Pages 127 - 130

Abstract: En | Text: En | PDF: En

https://doi.org/10.24875/acm.220001591

Forças Anteriores Proeminentes do QRS Durante Suboclusão Transitória do Tronco da Coronária Esquerda
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Pérez-Riera, Andrés Ricardo

; Barbosa-Barros, Raimundo

; Raimundo, Rodrigo Daminello

; Abreu, Luiz Carlos de

; Almeida, Marcos Célio de

; Nikus, Kjell

Arquivos Brasileiros de Cardiologia

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apr 2020, Volume 115 N. 1 Pages 1 - 5

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20180363 635 downloads

Unusual ventricular activation produced by temporary transvenous cardiac pacing: electrovectorcardiographic findings
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Pérez-Riera, Andrés R.

; Barbosa-Barros, Raimundo

; Baueb-Soler, Fábio

; Daminello-Raimundo, Rodrigo

; Abreu, Luiz C. de

; Nikus, Kjell

Archivos de cardiología de México

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mar 2020, Volume 90 N. 1 Pages 12 - 16

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Complete heart block (CHB) results from dysfunction of the cardiac conduction system, which results in complete electrical dissociation. The ventricular escape rhythm can have its origin anywhere from the atrioventricular node to the bundle branch-Purkinje system. CHB typically results in bradycardia, hypotension, fatigue, hemodynamic instability, syncope, or even Stokes-Adams syndrome. Escape rhythm originating above the bifurcation of the His bundle (HB) produces narrow QRSs with relatively rapid heart rate (HR) (except in cases of His system disease). We present a middle-aged man with an HR of 34 bpm, progressive fatigue, in whom a temporary pacemaker was implanted in the subtricuspid region. The post-intervention electrocardiogram had unusual features.

Resumen El bloqueo cardíaco completo (BCC) resulta de la disfunción del sistema de conducción cardíaco, lo que ocasiona una disociación eléctrica completa entre aurículas y ventrículos. El ritmo de escape resultante puede tener su origen en cualquier lugar desde el nodo auriculoventricular hasta el sistema His Purkinje. El BCC generalmente produce bradicardia, hipotensión, fatiga, inestabilidad hemodinámica, síncope o incluso el síndrome de Stokes-Adams. El ritmo de escape que se origina por encima de la bifurcación del haz de His produce intervalos QRS estrechos con frecuencia cardíaca no muy lenta (excepto en casos de enfermedad del sistema Hisiano). Presentamos a un hombre de mediana edad con una frecuencia cardíaca de 34 lpm, fatiga progresiva, en el que se implantó un marcapasos temporario en la región subtricuspídea. El electrocardiograma resultante a la intervención presentó características inusuales.

https://doi.org/10.24875/acme.m20000091 250 downloads

Complete Resolution of Electrocardiographic Changes Induced by Acute Chagas Myocarditis
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Valle, Joseane Elza Tonussi Mendes Rossette do

; Abreu, Luiz Carlos de

; Barros, Raimundo Barbosa

; Raimundo, Rodrigo Daminello

; Riera, Andrés Ricardo Pérez

; Sorpreso, Isabel

International Journal of Cardiovascular Sciences

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oct 2019, Volume 32 N. 5 Pages 546 - 550

Abstract: En | Text: En | PDF: En

Abstract We present a case of a female adolescent with severe acute Chagas myocarditis, acquired by oral transmission in an endemic area in the Brazilian western Amazon, who had electrocardiographic changes normalized after empirical treatment with the antiparasitic drug benznidazole combined with conventional treatment for severe heart failure.

https://doi.org/10.5935/2359-4802.20190010 309 downloads

Extensive Anterior Myocardial Infarction ... and Something Else?
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Riera, Andrés Ricardo Pérez

; Barros, Raimundo Barbosa

; Sousa Neto, Antônio Fernandes Silva e

; Raimundo, Rodrigo Daminello

; Abreu, Luiz Carlos de

; Nikus, Kjell

Arquivos Brasileiros de Cardiologia

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jun 2019, Volume 112 N. 6 Pages 803 - 806

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.5935/abc.20190096 2600 downloads

What do Cochrane systematic reviews say about new practices on integrative medicine?
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Riera, Rachel

; Braga, Vinícius Lopes

; Rocha, Luana Pompeu dos Santos

; Bernardo, Daniel Damasceno

; Andrade, Luísa Avelar Fernandes de

; Hsu, Jessica Chiu

; Silva, Luciana Di Giovanni Marques da

; Suetsugu, Rodrigo Cesar de Sá

; Dittrich, Nicole Hosni

; Lima, Lucas Riguete Pereira de

; Silveira, Vicente Penido da

; Kruglensky, Barbara Caon

; Leonel, Letícia de Freitas

; Barros, Edivando de Moura

; Costa, Anderson Adriano Leal Freitas da

; Quintella, Miguel Lins

; Pacheco, Rafael Leite

; Cruz, Carolina de Oliveira

; Martimbianco, Ana Luiza Cabrera

; Pachito, Daniela Vianna

; Mozetic, Vania

; Teixeira, Tatiana de Bruyn Ferraz

; Torloni, Maria Regina

; Atallah, Alvaro Nagib

Sao Paulo Medical Journal

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may 2018, Volume 136 N. 3 Pages 251 - 261

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: This study identified and summarized all Cochrane systematic reviews (SRs) on the effects of ten integrative practices that were recently added to the Brazilian public healthcare system (SUS). DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp). METHODS: Review of Cochrane SRs on the following interventions were identified, summarized and critically assessed: apitherapy, aromatherapy, bioenergetics, family constellation, flower therapy, chromotherapy, geotherapy, hypnotherapy, hand imposition or ozone therapy. RESULTS: We included a total of 16 SRs: 4 on apitherapy, 4 on aromatherapy, 6 on hypnotherapy and 2 on ozone therapy. No Cochrane SR was found regarding bioenergetics, family constellation, chromotherapy, clay therapy, flower therapy or hand imposition. The only high-quality evidence was in relation to the potential benefit of apitherapy, specifically regarding some benefits from honey dressings for partial healing of burn wounds, for reduction of coughing among children with acute coughs and for preventing allergic reactions to insect stings. CONCLUSION: Except for some specific uses of apitherapy (honey for burn wounds and for acute coughs and bee venom for allergic reactions to insect stings), the use of ten integrative practices that have recently been incorporated into SUS does not seem to be supported by evidence from Cochrane SRs.

https://doi.org/10.1590/1516-3180.2018.0172170418 2326 downloads

Factores sociales asociados con la utilización de los servicios de atención prenatal en Ecuador
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Sánchez-Gómez, Amaya

; Cevallos, William

; Grijalva, Mario J.

; Silva-Ayçaguer, Luis C.

; Tamayo, Susana

; Jacobson, Jerry O.

; Costales, Jaime A.

; Jiménez-Garcia, Rodrigo

; Hernández-Barrera, Valentín

; Serruya, Suzanne

; Riera, Celia

Revista Panamericana de Salud Pública

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nov 2016, Volume 40 N. 5 Pages 341 - 346

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Objectives Prenatal care is a pillar of public health, enabling access to interventions including prevention of mother-to-child transmission of HIV and congenital syphilis. This paper describes social factors related to use of prenatal care in Ecuador. Methods In 2011 and 2012, participant clinical history and interview information was analyzed from a national probability sample of 5 998 women presenting for delivery or miscarriage services in 15 healthcare facilities in Ecuador, to estimate prevalence of HIV, syphilis, and Chagas disease, and prenatal care coverage. Results The study found that 94.1% of women had attended at least one prenatal visit, but that attendance at no less than four visits was 73.1%. Furthermore, lower educational level, greater number of pregnancies, occupation in the agriculture or livestock sector, and membership in ethnic indigenous, Afro-Ecuadorian, or other minority groups were factors associated with lack of use (no prenatal visits) or insufficient use of prenatal care (fewer than four visits or first visit at >20 weeks gestation) in Ecuador. Conclusions These results point to persistence of marked inequalities in access to and use of prenatal health services attributable to socioeconomic factors and to the need to strengthen strategies to address them, to reach the goal of universal prenatal care coverage.

RESUMEN Objetivos La atención prenatal es uno de los pilares de la salud pública y permite el acceso a intervenciones tales como la prevención de la transmisión materno-infantil del VIH y de la sífilis congénita. Este artículo tiene como objetivo describir los factores sociales asociados con la utilización de los servicios de atención prenatal en Ecuador. Métodos Entre 2011 y 2012, se realizó un análisis de la información procedente de las historias clínicas y de la entrevista a las participantes, que integraron una muestra probabilística a nivel nacional de 5 998 mujeres atendidas por parto o aborto en 15 servicios sanitarios en Ecuador con el objetivo de estimar la prevalencia de VIH, sífilis, enfermedad de Chagas y la cobertura de atención prenatal. Resultados El estudio mostró que 94,1% de las mujeres había acudido a algún control prenatal, pero la asistencia al menos a cuatro controles fue 73,1%. Se encontró que el menor nivel educativo, el mayor número de embarazos, la ocupación en el sector agrícola o ganadero y la pertenencia a los grupos étnicos indígena, afroecuatoriano u otros minoritarios fueron factores asociados con la falta de uso (ningún control prenatal) o al uso inadecuado de la atención prenatal (menos de cuatro controles o primer control después de las 20 semanas de gestación) en Ecuador. Conclusiones Estos resultados apuntan a la persistencia de desigualdades marcadas en el acceso y en la utilización de servicios de atención prenatal atribuibles a factores socioeconómicos y a la necesidad de fortalecer las estrategias para su abordaje para alcanzar la meta de la cobertura universal de atención prenatal.

1071 downloads

Temporal Variations of Shallow Subtidal Meiofauna in Los Cristianos Bay (Tenerife, Canary Islands, Ne Atlantic Ocean)
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Riera, Rodrigo

; Nunez, Jorge

; Brito, Maria del Carmen

Brazilian Journal of Oceanography

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sep 2014, Volume 62 N. 3 Pages 167 - 177

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

As assembleias da meiofauna de Los Cristianos Bay, Tenerife, Ilhas Canárias, foi amostrada de maio de 2000 a abril de 2001 a 3 m de profundidade. Nematoda dominou durante todo o período de estudo, variando entre 84.52% em maio de 2000 a 95.93% em outubro do mesmo ano. Copepoda e Polychaeta foram o segundo e terceiro grupos mais abundantes, respectivamente. A densidade apresentou diferenças significativas ao longo do período, com valores mínimos na primavera-verão (maio-julho) e máximos no inverno (janeiro e fevereiro). Essa sazonalidade está sendo atribuída principalmente às variações temporais das espécies mais abundantes de nemátodes (Daptonema hirsutum e Pomponema sedecima). A meiofauna apresentou ainda diferenças na composição e abundância em maio e junho de 2000 quando comparado com os meses restantes do estudo. As variáveis ambientais explicaram parcialmente as variações na estrutura da comunidade e o tipo sedimentar areia muito fina destacou-se entre os mais importantes, juntamente com outras variáveis, tais como nitrogênio e conteúdo de matéria orgânica.

A subtidal meiofaunal assemblage in Los Cristianos Bay, Tenerife, Canary Islands was sampled from May 2000 to April 2001, at 3 m depth. Nematodes dominated overwhelmingly during the study period, ranging from 84.52% in May 2000 to 95.93% in October 2000. Copepods and polychaetes were the second and the third most abundant groups, respectively. Meiofaunal densities showed significant differences throughout the study period, with minimum abundances during the spring-summer months (May-July) and highest densities in winter (January and February). This seasonality is mainly due to the temporal variations of the most abundant species (nematodes Daptonema hirsutum and Pomponema sedecima), with differences in meiofauna species composition and abundance during May and June 2000 as compared to the remaining months of the study period. Environmental variables partly explained meiofaunal community structure, being the sedimentary type of very fine sands the most important, jointly with other variables, such as nitrogen and organic matter content.

https://doi.org/10.1590/S1679-87592014027406203 1555 downloads

Effects of organic enrichment on macrofauna community structure: an experimental approach
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Riera, Rodrigo

; Sacramento, Alicia

; Perez, Óscar

; Monterroso, Óscar

; Ramos, Eva

; Rodríguez, Myriam

; Almansa, Eduardo

Brazilian Journal of Oceanography

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dec 2013, Volume 61 N. 4 Pages 223 - 229

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A determinação da resiliência das assembleias bênticas é um assunto fundamental para a indústria da aquicultura de mar aberto como tentativa de minimizar as perturbações ambientais. Estudos experimentais são ferramenta importante para o estabelecimento das linhas de base para as comunidades do fundo oceânico. Nesse sentido, um experimento foi conduzido sob três tratamentos (controle, 1x e 3x), nos quais o aporte orgânico (pelotas fecais de peixes) foi adicionado nas quantidades de 1x (10 g de pelotas fecais) e de 3 vezes (30 g). Os resultados mostram que foi encontrada redução na abundância de indivíduos e também no número de espécies entre o controle e os tratamentos com enriquecimento orgânico. Mudanças significativas na estrutura das assembleias também foram encontradas, principalmente devido ao decréscimo do tanaidáceo sensível Apseudes talpa nos tratamento enriquecidos. Os índices AMBI e M-AMBI foram calculados e um decréscimo do status ecológico foi observado no tratamento 3x.

The determination of the resilience of benthic assemblages is a capital issue for the off-shore aquaculture industry in its attempts to minimize environmental disturbances. Experimental studies are an important tool for the establishment of thresholds for macrofaunal assemblages inhabiting sandy seabeds. An experiment was conducted with three treatments (Control, 1x and 3x),in which organic load (fish pellets) was added (1x (10 g of fish pellets) and 3x (30 g)). A reduction in abundance of individuals and species richness was found as between the control and organic-enriched treatments. Significant changes in assemblage structure were also found, mainly due to the decrease of the sensitive tanaid Apseudes talpa in organically-enriched treatments. AMBI and M-AMBI indices were calculated and a decrease of ecological status was observed in treatment 3x.

2502 downloads

10.

Influencia de la combinación de vertidos de aguas residuales y salmuera sobre la meiofauna
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Riera, Rodrigo

; Tuya, Fernando

; Sacramento, Alicia

; Ramos, Eva

; Monterroso, Óscar

; Rodríguez, Myriam

Ciencias marinas

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mar 2013, Volume 39 N. 1 Pages 15 - 27

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Confluence of anthropogenic influences is common in coastal areas (e.g., disposal of different pollutants like industrial and domestic sewage, brine, etc.). In this study we assessed whether the combined disposal of domestic sewage and brine altered patterns in the abundance and assemblage structure of subtidal meiofauna inhabiting sandy seabeds. Samples were collected in May 2008 and January 2009 at varying distances (0, 15, and 30 m) from the discharge point. Meiofaunal abundances were consistently larger at 0 m (1663.05 ± 1076.86 ind 10 cm-2, mean ± standard error) than at 15 m (471.21 ± 307.97 ind 10 cm-2) and 30 m (316.50 ± 256.85 ind 10 cm-2) from the discharge outfall. This pattern was particularly accentuated for nematodes. Proximity to the discharge point also altered patterns in meiofaunal assemblage structure, though temporal shifts in the sedimentary composition also contributed to explain differences in the meiofaunal assemblage structure. As a result, meiofauna may be a reliable tool for monitoring studies of the combined disposal of sewage and brine as long as potential confounding factors (here temporal changes in grain size composition) are considered.

La confluencia de diferentes impactos antropogénicos es común en áreas costeras marinas; por ejemplo, el vertido conjunto de varios contaminantes (aguas residuales industriales y domésticas, salmuera, etc.) en la misma zona. En este estudio, se examinó si el vertido combinado de aguas residuales domésticas y salmuera altera los patrones de abundancia y la estructura de la comunidad meiofaunal del medio submareal. Las muestras fueron recolectadas en mayo de 2008 y enero de 2009 a 0, 15 y 30 m de distancia del punto de vertido. Las abundancias meiofaunales fueron más elevadas en el punto de vertido (1663.05 ± 1076.86 individuos 10 cm-2, media ± error estándar) que a 15 m (471.21 ± 307.97 individuos 10 cm-2) y 30 m de distancia (316.50 ± 256.85 individuos 10 cm-2) del punto de vertido. Este patrón de abundancia ha sido acusado particularmente para los nematodos. La proximidad al punto de vertido alteró la estructura de la comunidad meiofaunal, aunque los cambios estacionales en la composición del sedimento también contribuyeron a explicar las diferencias en las abundancias meiofaunales y en la estructura de la comunidad. Como resultado, la meiofauna puede considerarse una herramienta fiable para estudios de seguimiento de vertidos combinados de aguas residuales y salmuera, siempre y cuando la presencia de factores enmascarantes, como los cambios estacionales en la composición granulométrica del sedimento, se incluyan en los diseños.

https://doi.org/10.7773/cm.v39i1.2162 2457 downloads

11.

Subtidal soft-bottom macroinvertebrate communities of the Canary Islands. An ecological approach
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Monterroso, Oscar

; Riera, Rodrigo

; Núñez, Jorge

Brazilian Journal of Oceanography

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mar 2012, Volume 60 N. 1 Pages 1 - 9

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O arquipélago das Canárias é caracterizado por um mosaico de fundos inconsolidados contendo bancos de Cymodocea nodosa, Caulerpa spp., fundos calcários, bancos de sabelídeos e sedimento não biogênico, que abrigam diferentes comunidades da macrofauna. Ambientes vegetados (Cymodocea e Caulerpa) possuem comunidades mais diversificadas quando comparados aos ambientes de fundos não vegetados. Os resultados do presente estudo indicaram que os bancos de Caulerpa, primeiramente, e em seguida os bancos de Cymodocea nodosa e de sabelídeos, formam os sistemas mais ricos e diversificados da área. Além disso, puderam também ser detectadas diferenças de biodiversidade entre as ilhas do arquipélago, sendo os valores mais altos localizados nas ilhas ao leste (Lanzarote e Gran Canaria) e os menores nas ilhas à oeste (La Palma).

The Canarian archipelago is characterized by a mosaic of soft-bottoms such as Cymodocea nodosa meadows, Caulerpa spp. meadows, mäerl bottoms, sabellid fields and bare sandy seabeds, including various macroinfaunal communities. Vegetated habitats (e.g. Cymodocea and Caulerpa) maintain more diverse communities than the non-vegetated seabeds. The results indicated that Caulerpa meadows and, to a lesser extent, Cymodocea nodosa and sabellid fields are the richest and most diverse ecosystems in the study area. Moreover, biodiversity differences among islands could be detected with maximum values on the eastern islands (Lanzarote and Gran Canaria) and lowest values on the western ones (La Palma).

1720 downloads

12.

Pausa inesperada. ¿Cuál es el mecanismo?
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Miranda Hermosilla, Rodrigo

; Femenía, Francisco

; Pérez Riera, Andrés R.

; Baranchuk, Adrián

Medicina (Buenos Aires)

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apr 2011, Volume 71 N. 2 Pages 166 - 166

Abstract: Es | Text: Es | PDF: Es

129 downloads

13.

Efeitos do intervalo de recuperação entre as séries sobre a pressão arterial após exercícios resistidos
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Veloso, João

; Polito, Marcos D.

; Riera, Tiago

; Celes, Rodrigo

; Vidal, José Carlos

; Bottaro, Martim

Arquivos Brasileiros de Cardiologia

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apr 2010, Volume 94 N. 4 Pages 512 - 518

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

FUNDAMENTO: Apesar de os estudos demonstrarem a ocorrência da hipotensão pós-exercício (HPE) em exercícios resistidos, ainda não há consenso sobre um protocolo ideal. OBJETIVO: Avaliar os efeitos de diferentes intervalos de recuperação (IR) entre séries de exercício resistido (ER) na pressão arterial (PA) pós-exercício. MÉTODOS: Dezesseis homens jovens sedentários e não hipertensos realizaram, de forma contrabalanceada três protocolos de ER com 1 (P1), 2 (P2) e 3 (P3) minutos de IR entre as séries, e um protocolo controle (CON). Os protocolos de ER consistiram em três séries de oito repetições em seis exercícios. As cargas utilizadas na 1ª, 2ª e 3ª série dos exercícios foram respectivamente 80, 70 e 60% de 1 repetição máxima (1RM). As medidas foram realizadas em repouso (REP), 15 (T15), 30 (T30), 45 (T45), 60 (T60), 75 (T75) e 90 (T90) minutos após a sessão. Foi realizada uma análise de variância fatorial (ANOVA) com post hoc LSD. RESULTADOS: Não foi encontrada alteração significativa na PA sistólica após os protocolos. Foi encontrado um aumento significativo da PA diastólica, após o CON, nos momentos T45 e T90. Ocorreu redução significativa na PA diastólica após P1 e P3, com duração de 30 e 15 minutos respectivamente. Não foram encontradas diferenças significativas nas respostas da PA sistólica e diastólica entre os protocolos com diferentes IR. CONCLUSÃO: Parece que o IR não influencia a redução da PA sistólica após uma sessão de ER. No entanto, foi encontrada uma queda na PA diastólica (P1 e P3) com duração de até 30 minutos.

BACKGROUND: Although studies have demonstrated the occurrence of postexercise hypotension (PEH) in resistance exercises, there is still no consensus on an ideal protocol. OBJECTIVE: To evaluate the effects of different rest intervals (RI) between resistance exercise (RE) sets on postexercise blood pressure (BP). METHODS: Sixteen sedentary non-hypertensive young men performed three RE protocols with RI of 1 (P1), 2 (2) and 3 (P3) minutes between the sets, as well as a control protocol (CON), in a counterbalanced manner. The RE protocols consisted of three sets of eight repetitions in six exercises. The loads used in the 1st, 2nd, and 3rd exercise sets were 80%, 70% and 60% of one repetition maximum (1RM), respectively. Measurements were taken at rest (RES), 15 (T15), 30 (T30), 45 (T45), 60 (T60), 75 (T75), and 90 (T90) minutes after the session. Factorial analysis of variance (Anova) was carried out, followed by post hoc LSD. RESULTS: No significant change was found in systolic BP after the protocols. A significant increase in diastolic BP was verified after CON at timepoints T45 and T90. Significant reduction in diastolic BP occurred after P1 and P3, with duration of 30 and 15 minutes, respectively. No significant differences were found in the systolic and diastolic BP responses between the protocols with different RI. CONCLUSION: RI does not seem to influence systolic BP reduction after an RE session. However, reductions in diastolic BP (P1 and P3) lasting up to 30 minutes were observed.

FUNDAMENTO: A pesar de que los estudios demuestran la aparición de hipotensión post-ejercicio (HPE) en Ejercicios de Resistencia, aún no existe consenso sobre un protocolo ideal. OBJETIVO: Evaluar los efectos de diferentes intervalos de recuperación (IR) entre series de ejercicios de resistencia (ER) en la presión arterial (PA) post-ejercicio. MÉTODOS: Dieciséis hombres jóvenes sedentarios y no hipertensos realizaron, de forma contrabalanceada, tres protocolos de ER con 1 (P1), 2 (P2) y 3 (P3) min de IR entre las series, y un protocolo control (CON). Los protocolos de ER consistieron en tres series de ocho repeticiones en seis ejercicios. Las cargas utilizadas en la 1ª, 2ª y 3ª serie de los ejercicios fueron respectivamente 80, 70 y 60% de 1RM. Las mediciones fueron realizadas en reposo (REP), 15 (T15), 30 (T30), 45 (T45), 60 (T60), 75 (T75) y 90 (T90) min luego de la sesión. Se realizó un análisis de varianza factorial (ANOVA) con post hoc LSD. RESULTADOS: No se halló alteración significativa en la PA sistólica luego de los protocolos. Se encontró un aumento significativo de la PA diastólica, luego del CON, en los momentos T45 y T90. Ocurrió una reducción significativa en la PA diastólica luego de P1 y P3, con una duración de 30 y 15 min respectivamente. No se hallaron diferencias significativas en las respuestas de la PA sistólica y diastólica entre los protocolos con diferentes IR. CONCLUSIÓN: Parece que el IR no tiene influencia sobre la reducción de la PA sistólica luego de una sesión de ER. Sin embargo, se encontró una caída en la PA diastólica (P1 y P3) con duración de hasta 30 min.

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14.

Neutropenia Inmune - Aloinmune neonatal: IgG sérica reactiva y fenotipo específico de los neutrófilos evaluados por citometría de flujo
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Riera, Norma E.

; Kantor, Gustavo L.

; Khoury, Marina

; Parias Nucci, Rodrigo

; Rapetti, María Cristina

; Aixala, Mónica

; Goldsztein, Sofia

; Flores, Gabriela

; De E. De Bracco, María M.

Medicina (Buenos Aires)

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oct 2006, Volume 66 N. 5 Pages 405 - 414

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Auto or alloantibodies reactive with neutrophils define immune neutropenia. Alloimmune neonatal neutropenia is caused by maternal sensitization to paternal neutrophil antigens, resulting in IgG antibodies that are transferred to the fetus through the placenta. We present the studies in 4 children from 3 families with neutropenia of unknown origin (two of them were brothers). They were evaluated by flow cytometry in parallel with leukoagglutination. Reference values were established for serum reactive IgG in healthy volunteers for three dilutions (1/2, 1/5 and 1/20), both for the autologous reaction (serum and cells of the same individual) and for the heterologous reaction (serum and cells of different individuals). Results were expressed by an index defined by the quotient of the mean fluorescence intensity of the patient's serum divided by that of the reference serum. Serum reactive/agglutinant factors and circulating immune complexes were evaluated in patients and parents serum. Neutrophil specific phenotypes were determined for HNA-1a, HNA-1b and HNA-2a. Reactive IgG/agglutinant factors were found in 4 children. Two maternal sera were reactive against paternal and/or children neutrophils. Circulating immune complexes were detected in 2/4 children sera and were negative in 3/3 maternal sera. Maternal/children incompatibility was detected in the four cases. The three mothers had the same phenotype: homozygous NA1/NA1, NB1+.

La neutropenia inmune se diagnostica por la presencia de auto o aloanticuerpos reactivos con los neutrófilos. La neutropenia aloinmune neonatal es consecuencia de la sensibilización materna a los antígenos específicos de los neutrófilos paternos que afectan al neonato al atravesar la barrera placentaria. Se presentan 4 casos de niños, 2 de ellos hermanos consanguíneos con doble vínculo. Se estudiaron los sueros de los pacientes y sus padres. Por citometría de flujo se establecen los valores de referencia de la IgG sérica reactiva con los neutrófilos en voluntarios sanos, para 3 diluciones (1/2, 1/5 y 1/20) en reacción autóloga (suero y células de un mismo individuo) y heteróloga (suero y células de diferentes individuos). Los resultados se expresan por un índice definido como el cociente entre la mediana de la intensidad de fluorescencia media del suero incógnita y la de un suero utilizado como referencia. Por leucoaglutinación se evaluó la dilución del suero 1/20. Se determinó el nivel de complejos inmunes circulantes. Se determinó el fenotipo, para los epitopes HNA-1a, HNA-1b y HNA-2a. En los 4 niños se encontró IgG reactiva y/o factores aglutinantes; 2/3 sueros maternos fueron reactivos con los neutrófilos del cónyuge y de los hijos. Los complejos inmunes circulantes fueron positivos en 2/4 sueros negativos en 3/3 sueros maternos. Se encontró incompatibilidad materno-infantil en los 4 casos. Las 3 madres tenían igual fenotipo: homocigotos NA1/NA1, NB1+. En síntesis, se presenta el hallazgo de 4 casos con neutropenia inmune: 3/4 auto-inmune, 1/3 se asocia a complejos inmunes circulantes y 1/4 con neutropenia neonatal aloinmune.

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