The Montmorillonite-Erucamide nanocomposite (MMT-EU) can be used to reduce and to control the values of coefficient of friction of low-density polyethylene films (LDPE), widely used by the food industry. In this work, the effect of the addition of 5 wt% and 10 wt% of MMT-EU on the mechanical properties of LLDPE films involving the weld region was investigated. The MMT-EU concentration range was defined considering its possible technological application as an additive to stabilize the friction coefficient of polymeric films. The result shows a significant improvement in the values of stiffness, strength and ductility of polymeric films. In addition, it did not change the coefficient of friction, but the brightness of the LLDPE films decreased and the opacity increased, due to the increase in the crystallinity degree of the LLDPE polymer promoted by MMT-EU, not being a problem for the application of these films.

Resumo Avaliar o Estado Nutricional (EN) permite rastrear desnutrição e obesidade, condições associadas a doenças crônicas não transmissíveis. O índice de massa gorda (IMG) destaca-se em relação aos indicadores tradicionais de EN. No entanto, propostas que definem limiares para IMG não são sensíveis para discriminar casos extremos (graus de obesidade ou magreza). Apenas uma proposta (NHANES) estabeleceu oito categorias de classificação EN (IMG), mas foi determinada por densitometria corporal total (DXA). Porém, DXA é caro e nem sempre disponível. O objetivo foi testar a validade do método NHANES usando bioimpedância elétrica (BIA) e dobras cutâneas (DOCs) para classificar o EN. O IMG de 135 (69 mulheres) universitários com idade entre 18 e 30 anos foi obtido por DXA, BIA e DOCs. A concordância foi testada entre os instrumentos (Bland-Altman) e classificações de EN (Qui quadrado e índice Kappa). O teste de concordância com a DXA indicou as DOCs subestimarem o IMG (-1,9 kg/m2) para ambos os sexos e a BIA em mulheres (-2,0 kg/m2). No entanto, as BIA superestimaram o IMG (1,4 kg/m2) nos homens, embora com menos viés. Não houve concordância entre as classificações de EN (NHANES) pelo IMG entre DXA e BIA/DOCs. A exceção ocorreu entre DXA e BIA em homens que apresentaram concordância “razoável” (k = 0,214; p = 0,001). Em conclusão, DOCs e BIA não mostraram concordância suficiente para substituir DXA pela classificação de EN, dentro dos limites NHANES. As ferramentas diferem para medir IMG e classificar categorias de EN (NHANES).

Abstract Assessment of the Nutritional Status (NS) allows screening for malnutrition and obesity, conditions associated with chronic non-communicable diseases. The fat mass index (FMI) stands out concerning traditional NS indicators. However, proposals that define thresholds for FMI are not sensitive to discriminate extreme cases (degrees of obesity or thinness). Only one proposal (NHANES), determined by total body densitometry (DXA), established eight categories of NS classification (FMI). However, DXA is expensive and not always clinically available. Our study aims to test the validity of the NHANES method using electrical bioimpedance (BIA) and skinfold thickness (ST) to classify NS. The FMI of 135 (69 women) university students aged 18 to 30 years old was determined using DXA, BIA, and ST. The agreement between the instruments (Bland-Altman) and the agreement coefficient in the NS classifications (Chi-square and Kappa index) were tested. The agreement test against DXA indicated that ST underestimated the FMI (-1.9 kg/m2) for both sexes and BIA in women (-2.0 kg/m2). However, BIA overestimated FMI (1.4 kg/m2) in men, although with less bias. There was no agreement between the NS classifications (NHANES) by FMI between DXA and BIA, or DXA and ST. The exception occurred between DXA and BIA in men who showed a slightly better consensus, considered “fair” (k = 0.214; p = 0.001). In conclusion, ST and BIA did not show enough agreement to replace DXA for NS classification, within NHANES thresholds. The FMI measurement tools for the NHANES classification of the categories of NS matters.

Abstract Introduction: functional limitation is a result of sarcopenia and is associated with loss of skeletal muscle mass (SMM). Cost-effective methods are important for the identification of sarcopenia. Objective: to propose cutoff points for normalized calf circumference (CC) in order to identify low SMM in older women based on their functional limitation. Methods: in this descriptive, cross-sectional study the CC values of a young female sample (n = 78) were used to establish cutoff points (-2 SD) for low SMM in older women (n = 67). Functional limitation was identified by the six-minute walk test (≤ 400 m). CC was normalized by body mass, height, and BMI. The diagnostic accuracy of CC was calculated with a ROC curve, using functional limitation as standard. Results: cutoff points and area under the curve (AUC) were: CC (≤ 28.5; 0.62); CC·body mass-1 (≤ 0.40; 0.63); CC·height-2 (≤ 8.52; 0.55) and CC·BMI-1 (≤ 1.10; 0.73). Only CC·BMI-1 achieved a desirable accuracy (AUC > 0.7) to distinguish functional limitation. Conclusion: the accuracy attained supports the use of CC·BMI-1 to identify low SMM in older women. In the clinical context it is possible to predict the risk of sarcopenia when sophisticated methods for determining SMM are not available.

Resumen Introducción: la limitación funcional es consecuencia de la sarcopenia y se asocia con la pérdida de masa muscular esquelética (MME). Los métodos rentables son importantes para la identificación de la sarcopenia. Objetivo: proponer puntos de corte para la circunferencia de la pantorrilla (CP), normalizada para identificar un MME bajo en mujeres mayores en función de su limitación funcional. Métodos: en este estudio descriptivo de carácter transversal se utilizaron los valores de CP de una muestra de mujeres jóvenes (n = 78) para establecer los puntos de corte (-2 DS) de la MME baja en las mujeres mayores (n = 67). La limitación funcional se identificó mediante la prueba de la marcha de seis minutos (≤ 400 m). La CP se normalizó por la masa corporal, la altura y el IMC. La precisión diagnóstica de la CP se calculó con la curva ROC, utilizando como estándar la limitación funcional. Resultados: los puntos de corte y el área bajo la curva (AUC) fueron: CP (≤ 28,5; 0,62); CP·masa corporal-1 (≤ 0,40; 0,63); CP·altura-2 (≤ 8,52; 0,55) y CP·IMC-1 (≤ 1,10; 0,73). Solo el CP·IMC-1 logró la precisión deseable (AUC > 0,7) para distinguir la limitación funcional. Conclusión: la precisión alcanzada respalda el uso de CP·IMC-1 para identificar la MME baja en las mujeres mayores. En el contexto clínico es posible predecir el riesgo de sarcopenia cuando no se dispone de métodos sofisticados para determinar la MME.

Abstract Introduction: sarcopenia is a disease characterized by reduced musculoskeletal tissue and muscle strength. The estimation of appendicular lean soft tissue by DXA (ALSTDXA) is one of the criteria for the diagnosis of sarcopenia. However, this method is expensive and not readily avaiable in clinical practice. Anthropometric equations are low-cost and able to accurate predict ALST, but such equations have not been validated for male Brazilian older adults between the ages of 60 to 79 years. To this end, this study sought to validate the existing predictive anthropometric equations for ALST, and to verify its accuracy for the diagnosis of sarcopenia in male Brazilian older adults. Methods: this cross-sectional study recruited and enrolled 25 male older adults (69.3 ± 5.60 years). ALSTDXA and anthropometric measures were determined. ALST estimations with 13 equations were compared to ALSTDXA. The validity of the equations was established when: p > 0.05 (paired t-test); standard error of the estimate (SEE) < 3.5 kg; and coefficient of determination r² > 0.70. Results: two Indian equations met the criteria (Kulkarini 1: 22.19 ± 3.41 kg; p = 0.134; r² = 0.78; EPE = 1.3 kg. Kulkarini 3: 22.14 ± 3.52 kg; p = 0.135; r² = 0.82; SEE = 1.2 kg). However, these equations presented an average bias (Bland-Altman: 0.54 and 0.48 kg) and ‘false negative’ classification for the ALST index. Thus, three explanatory equations were developed. The most accurate equation demonstrated a high level of agreement (r2adj = 0.87) and validity (r²PRESS = 0.83), a low predictive error (SEEPRESS = 1.53 kg), and an adequate ALST classification. Conclusion: anthropometric models for predicting ALST are valid alternatives for the diagnosis and monitoring of sarcopenia in older adults; however, population specificity affects predictive validity, with risks of false positive/negative misclassification.

Resumen Introducción: la sarcopenia es una enfermedad caracterizada por una reducción del tejido musculoesquelético y la fuerza muscular. Uno de los criterios utilizados para su diagnóstico es la determinación de tejido blando magro apendicular por DXA (TBMADXA), método costoso que no siempre está disponible en la práctica clínica. Las ecuaciones antropométricas suponen un bajo coste y predicen bien el TBMA, pero con una validez desconocida para los varones brasileños de 60 a 79 años. Por lo tanto, nuestro objetivo fue validar las ecuaciones antropométricas existentes predictivas del TBMA y verificar su precisión para el diagnóstico de sarcopenia en varones brasileños de edad avanzada. Métodos: participaron en este estudio transversal 25 hombres de edad avanzada (69,3 ± 5,60 años). Se determinaron el TBMADXA y las medidas antropométricas. Las ecuaciones predictivas del TBMA se compararon con el TBMADXA. La validez de las ecuaciones en las comparaciones se confirmó cuando: p > 0,05 (prueba de la “t” pareada); error estándar estimado (EEE) < 3,5 kg; coeficiente de determinación r² > 0,70. Resultados: dos ecuaciones indias cumplieron los criterios (Kulkarini 1: 22,19 ± 3,41 kg; p = 0,134; r² = 0,78; EEE = 1,3 kg. Kulkarini 3: 22,14 ± 3,52 kg; p = 0,135; r² = 0,82; EEE = 1,2 kg). Sin embargo, presentaron sesgo promedio (Bland-Altman: 0,54 y 0,48 kg) y clasificación de ‘falso negativo’ para el índice de TBMA. Por lo tanto, se crearon tres ecuaciones explicativas. La ecuación más precisa mostró un alto acuerdo (r2adj = 0,87), uma alta validez (r²PRESS = 0,83), um bajo error predictivo (EEEPRESS = 1,53 kg) y uma clasificación del TBMA adecuada. Conclusión: los modelos antropométricos para predecir el TBMA son alternativas válidas para el diagnóstico y el seguimiento de la sarcopenia en los ancianos. Pero la especificidad de la población afecta a su validez predictiva, con riesgos de incorrección por clasificación falsa positiva/negativa.

Abstract Introduction: currently, there is no consensus regarding accurate and low-cost methods for diagnosing lipodystrophy in people living with HIV/AIDS (PLWHA). The aim of this study was to propose anthropometric cutoff points for the diagnosis of lipodystrophy among PLWHA. Methods: we included 106 PLWHA (men = 65, women = 41) who are under antiretroviral therapy and have been clinically classified into either a “lipodystrophy” or “non-lipodystrophy” group. Anthropometric measurements included 19 regions of body perimeters and 6 skinfold thickness measures. The Youden index was used to establish anthropometric cutoff points for the diagnosis of lipodystrophy, using the mean values of the anthropometric data (referred to as “original”) along with the “Z index” (ZI) values, which were adjusted by the “Phantom Strategy.” The cutoff points were proposed when “original” anthropometric measurements and ZI values had a statistical significance of p < 0.01 and an area under the curve (AUC) higher than 70%. The size effect was assessed to verify the influence of lipodystrophy on each anthropometric measure. Results: our data analysis proposes sex-specific cutoff points for the diagnosis of lipodystrophy in PLWHA – 17 points using the “original” anthropometric measurements, and 20 using the ZI values (average effect size between 1.0 and 1.1, and AUC = 76.7% and 78%). Conclusions: our study proposes accurate cutoff points for the diagnosis of lipodystrophy using “original” anthropometric measurements and ZI values adjusted by the “Phantom Strategy.” Our findings support the use of anthropometric measurements as a simplified method for diagnosing lipodystrophy and monitoring body composition alterations in people living with HIV/AIDS.

Resumen Introducción: no existe consenso con respecto a métodos precisos y de bajo coste para diagnosticar la lipodistrofia en personas que viven con VIH/SIDA (PVVS). El objetivo de este estudio es proponer puntos de corte antropométricos para el diagnóstico de lipodistrofia entre las PVVS. Métodos: se incluyeron 106 PVVS (hombres = 65, mujeres = 41) en tratamiento antirretroviral que se clasificaron clínicamente en dos grupos de “lipodistrofia” o “no lipodistrofia”. Las mediciones antropométricas incluyeron 19 regiones de parámetros corporales y 6 medidas de pliegues cutáneos. El índice de Youden se utilizó para establecer puntos de corte antropométricos para el diagnóstico de lipodistrofia utilizando la media de los datos antropométricos (denominados “originales”) junto con los valores del “índice Z” (IZ), que fueron ajustados por la “estrategia Phantom”. Los puntos de corte se propusieron cuando las mediciones antropométricas “originales” y los valores de IZ fueron estadísticamente significativos con un valor p < 0,01 y un área bajo la curva (AUC) superior al 70%. Se evaluó el tamaño del efecto para verificar la influencia de la lipodistrofia en cada medida antropométrica. Resultados: se propusieron puntos de corte específicos según el sexo para el diagnóstico de lipodistrofia en PVVS: 17 puntos usando las medidas antropométricas “originales” y 20 usando los valores de IZ (tamaño del efecto promedio entre 1.0 y 1.1, y AUC = 76.7% y 78%). Conclusiones: se propusieron puntos de corte antropométricos para el diagnóstico de lipodistrofia. Las mediciones antropométricas son un método simplificado para diagnosticar y monitorear los cambios de composición corporal en las PVVS.

Resumo Ressonância magnética e tomografia computadorizada são referências para medir o tecido muscular (TM), porém apresentam custo elevado. A Absorciometria Radiológica de Dupla Energia (DXA) é segura, embora ainda dispendiosa, permite medir a Massa Isenta de Gordura e Osso apendicular (MIGOap), forte preditor do TM. Alternativamente, existem modelos antropométricos preditivos da MIGOap de atletas portugueses com baixo custo/risco, porém sem validação para outras populações. Objetivou-se validar modelos antropométricos portugueses preditivos da MIGOap em jovens atletas ou propor novos modelos, caso a validação falhe. A determinação da MIGOapDXA de 174 jovens atletas foi realizada por DXA. Dois modelos antropométricos (MIGOapmdJ1 e MIGOapmd2) de atletas portugueses foram testados para predizer MIGOap. Para validação o coeficiente de determinação, a diferença (viés) e a concordância entre valores medidos e preditos foram calculados. Finalmente, a associação entre média-e-diferença dos métodos foi calculada. A validação falhou, assim foram propostos novos modelos de regressão múltipla validados por estatística PRESS. Os modelos portugueses explicaram ~96% da variabilidade da MIGOapDJAf A diferença entre MIGOapmod1 e MIGOapDXA (-0,7kg) foi menor do que MI-GOapmod2 (-2,3kg), com limites de concordância de3,6 a -2,1 e de 6,1 a -1,5kg, respectivamente. Os novos modelos incluíram três equaçõespreditivaspara MIGOap. Somente MIGOapmd1foi válido, todavia mostrou grande tendência a vieses, conforme magnitude dos valores de MIGOap. Os novos modelos propostos mostraram validade com maior concordância (r2PRESS=0,98), menores erros de estimativa (EPEPRESS =0,91) e valores preditos mais homogêneos para casos extremos.

Abstract Magnetic resonance imaging and Computer tomography are gold standards in the measurement of muscle tissue (MT), but are expensive. Dual Energy X-Ray Absorptiometry (DXA) is also costly but safer and allows for the measurement of Appendicular Lean Soft Tissue (ALST), a strong predictor of MT. Alternatively, there are anthropometric models that predict the ALST of Portuguese athletes with low cost/risk that have not been validated in other populations. The aim of this study was to validate anthropometric Portuguese models that predict ALST in young athletes or, if the validation fails, to propose new models. The ALSTDXA of 174 young athletes was determined by DXA. Two anthropometric models (ALSTmod1 and ALSTmod2) measuring ALST among Portuguese athletes were tested. To validate the coefficient of determination, the difference (bias) and concordance correlation coefficient between predicted and actual values were computed. Finally, association between mean and difference of methods was verified. Validation failed and, for this reason, new multiple regression models were proposed and validated using PRESS statistics. The Portuguese models explained ~96% of the ALSTDXA variability. The difference between ALST (-0.7kg) was less than that found for the ALSTmod2 and ALSTDXA limits of agreement from 3.6 to -2.1 and from 6.1 to -1.5kg, respectively. The new models included three predictive equations for ALST. Only ASLTmod1was valid; however, it was prone to bias, depending on the magnitude of ALST values. The newly proposed models present validity with greater concordance (r2PRESS=0.98), lower standard error of estimate (SEEPRESS [kg]=0.91) and more homogeneous predicted extreme values.

Objetivou-se avaliar a viabilidade econômica de dietas contendo quatro silagens de cana-de-açúcar: sem aditivo; com 1% de ureia; com 0,5% de CaO + 0,5% ureia; e com 1% de CaO. Utilizaram-se oito vacas mestiças Holandês × Gir, distribuídas em dois quadrados latinos 4 × 4, compostos de quatro dietas, quatro animais e quatro períodos. A cana-de-açúcar utilizada foi a variedade SP 79-1011, com produção de 140 t/ha/ano, no terceiro corte. O corte da cana-de-açúcar foi feito manualmente e a cana, desintegrada em picadeira estacionária. O custo de produção dos volumosos, do concentrado e da dieta total foi analisado e, de acordo com os preços obtidos no mercado local, também foi calculado o COE (custo operacional efetivo). A dieta contendo silagem de cana-de-açúcar com 1% de ureia foi menos eficiente, pois resultou em baixo consumo e maior perda de peso das vacas podendo afetar a produção de leite e o escore corporal das vacas no decorrer da lactação.

This aimed to evaluate the economic viability of diets containing four sugar cane silages: without additive, with 1% urea, with 0.5% CaO + 0.5% urea and ; with 1% CaO. Eight crossbred cows (Holstein x Gir) were used, arranged in two 4 x 4 Latin squares compounds of the: four diets, four animals and four periods. The sugar cane used was the variety SP 79-1011, with a yield of 140 t/ha/year in the third cut. The cut of sugar cane was done manually and the cana disintegrated in stationary chopper. The production costs of the roughage, concentrated and total diet were analyzed of the according to the prices of the local market, it was also estimated the EOC (effective operational cost). The diet containing silage sugar cane with 1% urea was less efficient because low consumption and resulted in greater weight loss of cows may affect milk production and body condition score of cows during the lactation period.

OBJETIVOS: Apresentar o modelo experimental de neurocisticercose (NCC) com cisticercos de Taenia crassiceps, descrever a inflamação, suscetibilidade e resistência em camundongos BALB/c e C57BL/6, caracterizando melhor a relação parasito-hospedeiro. MÉTODOS: Os animais foram inoculados intracranialmente com cisticercos de T. crassiceps em estádio inicial e eutanasiados aos 7, 30, 60 e 90 dias após a infecção. Retiraram-se os encéfalos para análise histopatológica, classificação dos parasitos e lesões inflamatórias. RESULTADOS: Foi possível induzir NCC nas duas linhagens de camundongos utilizados como modelo experimental. Os animais BALB/c apresentaram lesões inflamatórias mais intensas do que os camundongos C57BL/6 e induziram nos parasitos necrose na fase tardia com padrão inflamatório agudo. Os C57BL/6 mostraram-se mais hábeis em provocar necrose precocemente nos cisticercos, mas com padrão inflamatório crônico. CONCLUSÕES: Este modelo experimental induziu NCC nos animais com inflamações e lesões. Os camundongos C57BL/6 foram hábeis em induzir precocemente necrose nos parasitos, apresentando lesões inflamatórias com menor intensidade.

OBJECTIVES: To present the experimental model of neurocysticercosis (NCC) caused by Taenia crassiceps cysticerci, to describe the inflammatory process, susceptibility, or resistance of BALB/c and C57BL/6 mice to this infection, and to describe the host-parasite relationship. METHODS: The animals were intracranially inoculated with initial stage T. crassiceps cysticerci. They were euthanized at 7, 30, 60, and 90 days after the inoculation. Their encephala were removed for the histopathologic analysis, classification of the parasites, and inflammatory lesions. RESULTS: Experimental NCC was observed on both mice lineages. BALB/c mice presented inflammatory lesions with greater intensity, inducing necrosis on late stage parasites, and with an acute inflammation pattern, while C57BL/6 mice showed greater capability on provoking early necrosis in the cysticerci, which showed a chronic inflammation pattern. CONCLUSIONS: This experimental model induced NCC on mice with characteristic inflammation and lesions. C57BL/6 mice were able to induce precocious necrosis of the parasites presenting inflammatory lesions with lower intensity.

Com o objetivo de avaliar o efeito da irrigação e épocas de colheita, sobre a produtividade e características agronômicas da mandioca (Manihot esculenta Crantz), conhecida como Coqueiro, foi desenvolvido um ensaio em condições de sequeiro e irrigado. O delineamento experimental foi em blocos casualisados, com quatro repetições, tendo como tratamentos as épocas de colheita (8, 10, 12, 14, 16 e 18 meses após o plantio). Os resultados permitiram concluir que plantas irrigadas apresentaram valor de índice de área foliar 39% maiores e valores de altura 14% maior que plantas cultivadas em sequeiro. A produtividade de raízes não foi influenciada, significativamente, pela irrigação, mas aumentou linearmente com a idade e épocas de colheita. Aos 18 meses, plantas de mandioca produziram 40.590,60 kg ha-1 de raízes, incremento de 100% em relação à colheita efetuada aos 8 meses. A percentagem de amido em raízes, em cultivo de sequeiro, decresceu com as épocas de colheita. Sob irrigação, a partir dos 14 meses, essa tendência se modificou com aumento dos valores.

In order to assess the effect of irrigation and harvest time on productivity and other agronomical characteristics of cassava (Manihot esculenta Crantz) known as Coqueiro, one experiment was developed under conditions of dry land and irrigation. A randomized block design was applied, with four replicates and treatments composed by different harvest seasons (8, 10, 12, 14, 16 and 18 months after planting). Plants submitted to irrigation had a 39% increase in leaf area and 14% in height, in comparison to those on dry land. Irrigation did not affect root productivity, but increase linearly according to harvest time. 18 months after being sowed, a root productivity of 40,590.60 kg ha-1 was obtained, an increment of 100% in comparison to harvest realized in an 8-month period. The starch content of roots, cultivated without irrigation, had a tendency to decrease in relation to harvest time. With irrigation, this tendency was reverted, with an increase of values.

Na revascularização do miocárdio com o coração batendo, a exposição das artérias posteriores durante a esternotomia pode levar à deterioração hemodinâmica necessitando um suporte inotrópico. Estudos experimentais recentes demonstraram o benefício hemodinâmico da assistência ventricular direita (AVD). OBJETIVO: Avaliar os efeitos hemodinâmicos da AVD durante a manipulação cardíaca para expor as artérias coronárias posteriores, determinando seu efeito em: restaurar a hemodinâmica, aumentando a exposição anastomótica e diminuindo o uso de inotrópicos. CASUÍSTICA E MÉTODOS: Onze pacientes (6 homens / 5 mulheres), com idade média de 63,3 anos (49-74) foram revascularizados utilizando AVD. Todos tiveram pelo menos 1 ramo da artéria circunflexa (CX) revascularizado. A parede anterior foi revascularizada sistematicamente sem circulação extracorpórea (CEC) ou AVD. A artéria coronária direita (CD) e o ramo da CX foram completados em AVD. A pressão arterial média (PAM), a pressão média da artéria pulmonar (PAP) e o débito cardíaco (DC) foram registrados durante as anastomoses CD e CX. RESULTADOS: Os dados foram registrados da seguinte maneira: 1) base em normoposição; 2) CX em posição AVD Off; 3) CX em posição AVD On; 4) CD em posição AVD Off; 5) CD em posição AVD On. <img src="http:/img/fbpe/rbccv/v15n4/a01img01.gif"> CONCLUSÕES: A AVD suporta e facilita a revascularização sem CEC para as artérias coronárias posteriores, restaurando a hemodinâmica, possibilitando melhor exposição para as anastomoses e, aparentemente, reduzindo a necessidade de uso de inotrópicos. Estudos prospectivos randomizados são necessários para confirmar esta experiência inicial.

OBJECTIVES: During coronary surgery without CPB, exposure of posterior vessels via sternotomy can cause deterioration of cardiac hemodynamics, requiring inotropic drug support. Recent animal experiments demonstrate the hemodynamic benefit of right heart support (RHS) with the A-MED system. The aim of this study is to evaluate the hemodynamic effect of RHS in: restoring hemodynamics, increasing anastomotic exposure and reducing inotropic requirements. MATERIAL AND METHODS: Eleven patients received coronary revascularization with the A-MED RHS device. All had at least 1 circumflex branch bypassed. The anterior wall was systematically bypassed off pump without RHS. The right coronary artery (RCA) and the obtuse coronary artery (OM) were completed utilizing RHS. Mean arterial pressure (MAP), mean pulmonary arterial pressure (PAP), cardiac output (CO) and the average pump flow (APF) were recorded during the OM and RCA bypass. RESULTS: Elective beating heart coronary artery graft (CABG) was successfully accomplished in 11 patients with RHS. Data measurements recorded showed the improved hemodynamic recovery for OM and RCA bypass with RHS. The MAP increased from 44 to 63 mmHg (OM) and from 63 to 81 mmHg (RCA). No device-related patient incidents occurred. All 11 patients were discharged to their homes. CONCLUSIONS: The AMED system as RHS support facilitated coronary bypass without CPB to posterior vessels, restoring hemodynamics, providing better exposure to anastomic sites and apparently reducing the need for inotropic support.