Repositório RCAAP

Best tillage practices for eucalyptus growth and productivity: A review on the Brazilian experience

ABSTRACT Commercial eucalyptus forestry has significantly increased in the last decades to supply the growing demand for forest goods (pulp, paper, sawmill, by-product industries, and biomass for bioenergy and biofuels). Among factors most influencing forest productivity, the soil physical environment is very important and can be harmful or beneficial to trees. In the effort to increase environmental and economic sustainability of commercial plantations, in this literature review, we summarize relationships between soil type and properties, forest rotation, and forest growth and productivity. Mechanized soil tillage must consider soil type, particularly land slope, soil drainage and depth, along with forest rotation (first or higher-order). Soil surveys, including soil physical properties (e.g., compaction, granulometry including gravel) and morphological attributes (e.g., horizons, solum depth, subsurface drainage impedance), are thus essential for foresters to make knowledgeable decisions on soil tillage, provided tillage is the single most costly practice in eucalyptus forestry. Subsoiling is the most common soil tillage for eucalyptus, but it is best for deep, drained soils. Existing scientific publications show, for clayey cohesive or compacted soils, tillage depth might be of 0.70 m (deep subsoiling) to ameliorate compacted soil of low microporosity and restriction to root growth, but 0.50 m (shallow) subsoiling plus ridding produce similar results. The latter, nonetheless, has a higher operational cost. Downslope subsoiling on sloppy lands increases the risk for soil erosion, which may be reduced by interrupting ripping, mechanized hole- or pit-drilling with low operational cost. Chiseling performed for fertilizer application (minimum 0.25 m deep) might be the only tillage required for non-compacted sandy soils. Mechanical or manual pitting could also be an option for second or higher rotations, but results show crop early-growth is restricted, possibly because of root confinement. For second or higher rotations, stumps require cutting to allow cross-slope tractor traffic and tillage. Subsoiling plus ridging or bedding is required in low-drainage or shallow soils to increase the soil volume to be explored by roots. The ridges can be built by grade bedding or terracing plows. In areas with waterlogging, drainage and ridging without subsoiling are necessary. Research opportunities include further studies for slopy lands and low-drainage or compacted soils, tillage affecting soil erosion and eucalyptus productivity, equipment for special tillage, and mapping compaction risk and special tillage needs.

Ano

2022

Creators

Santos,Kristiana Fiorentin dos Reichert,José Miguel

Nitrogen use efficiency and grain yield of corn hybrids as affected by nitrogen rates and sowing dates in subtropical environment

ABSTRACT Delay of sowing date in subtropical environments with long growing seasons can modify the yield response of corn hybrids to nitrogen (N) fertilization. This study evaluated the effects of the sowing time, and N top-dress rate on corn hybrids’ yield and N-use efficiency with different cycles. Two field experiments were carried out in subtropical environment of southern Brazil. The following factors were investigated: corn hybrids (AG9025, super early cycle and P30F53, early cycle), sowing times (early and late spring), and N top-dress rates (0, 150, 300 and 450 kg ha-1). The delay of sowing date from early to late spring reduced 10 % the number of kernels per ear, decreasing grain yield. Corn presented lower yield potential in late sowings (-24 %), associated with a smaller response of grain yield to the N rate increase. The maximum corn yield was achieved at a rate of 360 kg ha-1 of N in early spring sowing and 300 kg ha-1 in late spring. The hybrid with early cycle presented greater yield stability and higher N use efficiency than the super early cycle hybrid in the late sowing. The N agronomic efficiency use is 47 % lower in late spring sowing than in early spring sowing. Regardless of the sowing date, the N use efficiency decreased 0.08 for each kg ha-1 N rate increase. This study suggests a reduction of at least 20 % in the N top-dress rate when the sowing date of corn is delayed to late spring in southern Brazil to decrease N losses and production costs.

Ano

2022

Creators

Coelho,Antonio Eduardo Sangoi,Luis Balbinot Junior,Alvadi Antonio Kuneski,Hugo François Martins Júnior,Marcos Cardoso

Adoption of the no-tillage system in Paraná State: A (re)view

ABSTRACT The concept of a no-tillage system (NTS), or “Sistema Plantio Direto,” was established in Brazil from the evolution of no-tillage (NT) or “Plantio Direto,” given the edaphoclimatic conditions and the need to promote chemical, physical and biological improvements in cultivated soils. While “Plantio Direto” is a conservationist practice, “Sistema Plantio Direto” presents itself as an agricultural production system based on the simultaneous adoption of minimum soil disturbance, maintenance of permanent soil cover and crop rotation. This study reviews the concepts of “Plantio Direto” and “Sistema Plantio Direto” in the Brazilian literature and uses two case studies in Paraná State to demonstrate the practical implications of these concepts. These two terms and their variations are recurrent themes in Brazilian scientific research and the professional environment, and may occur erroneously, hindering their adoption, results and implications. Regarding the “Sistema Plantio Direto,” we highlight the need to clarify the concepts of its basic practices to parameterize and characterize this process. The definition of crop rotation, for example, requires limits on the number of species along a given time scale, thus enabling their identification. Regarding the case studies, most grain crops conducted in Paraná State did not adopt the “Sistema Plantio Direto,” mainly neglecting the component of crop rotation. Nevertheless, the use of the “no-tillage system participatory quality index” (PQI) tool can contribute to the assessment and monitoring of the quality of the “Sistema Plantio Direto.” However, it requires adjustments to differentiate the “Sistema Plantio Direto” from the “Plantio Direto.”

Ano

2022

Creators

Possamai,Edivan José Conceição,Paulo Cesar Amadori,Caroline Bartz,Marie Luise Carolina Ralisch,Ricardo Vicensi,Marcelo Marx,Ericson Fagundes

Nitrogen release from pelletized poultry fertilizer in two soils: influence of soil moisture and microbial biomass

ABSTRACT Nitrogen release from organic amendments, e.g., from organic agriculture, is a key process to raise soil fertility to sustain crop production in low environmental impact agroecosystems. This study aimed to investigate nitrogen release from a pelletized organic amendment containing poultry litter, guano and pot ale applied to soil from a field under two different management systems: an alfalfa-based crop rotation, enriched with N by the legume, under low-intensity tillage and a cereal-sunflower crop rotation under high-intensity tillage. Both sample types were evaluated under different temperature and soil moisture conditions (optimal and variable). The influence of the released amount of N-NO 3 on soil microbial biomass, soil basal respiration as well as on β-glucosidase, alkaline phosphatase and o-diphenoloxidase were investigated. The soil fertility level under low-intensity was higher than under high-intensity tillage. Consequently, compared to the control, microbial biomass growth in pellet-treated samples was intensified, both under optimal and variable conditions. Nevertheless, at the end of the experiment under variable conditions, microbial biomass decreased down to the level of the control. Soil moisture was identified as the limiting factor for basal respiration in low-tillage soil, while in the intensively tilled soil, low fertility was limiting, and respiration increased in response to pellet application, supplying C for microbial biomass. During the experimental period, the investigated enzyme activities were somewhat intensified by pellet application, contributing slightly to improve soil biochemical fertility. More N-NO 3 was released from soil under low than high-intensity tillage; however after 90-days, the pellet was not completely mineralized, and even at optimal soil moisture content, nitrate release was only partial. This indicated that pelletizing, though useful for practical reasons such as handling, storage and field distribution, can reduce the fertilization efficiency of organic amendments.

Ano

2022

Creators

Monaci,Elga Angeletti,Carlo Casucci,Cristiano Vischetti,Costantino

Cover crops and controlled-release urea decrease nitrogen mobility and improve nitrogen stock in a tropical sandy soil with cotton cultivation

ABSTRACT Sandy soil often has low nitrogen (N) stock. Thus, crops grown in sandy soil rely on high levels of N fertilization. The use of cover crops and efficient fertilizers can increase N stock in the soil and N availability in the topsoil, and reduce overall fertilizer costs. The objective of this study was to evaluate the effects of cover crops (fallow, a single grass species (ruzigrass), two grass species (ruzigrass + millet), one grass species (millet) with legumes [lime-yellow pea (2018) and velvet bean (2019)], and a mixture of three cover crops [two grass species (ruzigrass + millet) and one legume (lime-yellow pea (2018)] and velvet bean (2019), N sources (conventional urea and controlled-release urea) and N doses (70, 100 and 130 kg ha-1) on N dynamics in an Oxisol (Latossolo) with sandy texture in Brazil cultivated with cotton. Systems with the cover crops (average) had 17 % more total N stock in the soil than fallow systems. Inorganic N increased only in systems with legumes. The systems with cover crop mixtures had 70 % more ammonium than fallow systems. Systems only with grass species had low percentages of inorganic N in relation to total N in the soil. The increase in N-fertilizer rates augmented the N stock in the soil (total and inorganic). In the first year, controlled-release urea reduced the availability of inorganic N in cotton flowering, except for the system with mixed cover crops. After the cotton harvest, areas of controlled-release urea application had 12 % more inorganic N than the areas with conventional urea. Our findings show that the combined use of cover crops with high biomass production, moderate dose of N and controlled-release N can increase the availability of inorganic nitrogen in the upper layers of the soil in tropical areas with sandy soil and this can reduce nitrogen fertilizer consumption in the medium and long term in cotton fields.

Ano

2022

Creators

Cordeiro,Carlos Felipe dos Santos Rodrigues,Daniel Rodela Rorato,Ana Flávia de Souza Echer,Fábio Rafael

Rainfall erosivity estimation: Comparison and statistical assessment among methods using data from Southeastern Brazil

ABSTRACT Rainfall erosivity (R factor) is one of the six factors of the Universal Soil Loss Equation, being calculated based on the product of rainfall kinetic energy multiplied by its 30-minute maximum intensity. However, the lack of detailed and reliable rainfall data in many parts of the world has driven the use of other methods to estimate rainfall erosivity based on daily, monthly or annual data. These methods still need to be assessed to determine if their estimates are consistent with the standard method for calculating rainfall erosivity. This study aimed to select a consistent method for such replacement in Brazilian conditions without access the rainfall intensity data. The tested methods included: modified Fournier, MF; modified Fournier by Zhang, MF-Z; modified Fournier by Men, MF-M; Rainfall Disaggregation, RD; TRMM Satellite with modified Fournier coefficient, TRMM-F; and TRMM Satellite with monthly rainfall, TRMM-M. The rainfall data were obtained from the USP Meteorological Station, referring to the period from 2009 to 2015. The analyses were performed according to the Additive Main effects and Multiplicative Interaction (AMMI) model and Scott-Knott statistical tests. Considering the 1:1 line, all methods had a good adjustment, presenting similar behavior in relation to the standard method. The methods behaved differently for monthly and annual periods. The MF method proved to be capable of consistently replacing the standard method in all aforementioned situations. Considering the driest period, any method can be used. For annual rainfall erosivity estimation, the RD, MF, TRMM-F and TRMM-M methods can be applied; highlighting that the TRMM-based methods are optimal for locations without on-site rain gauges. Additionally, it was computed that the modified Fournier by Men and the modified Fournier by Zhang underestimated and overestimated the rainfall erosivity, respectively.

Ano

2022

Creators

Cardoso,Dione Pereira Avanzi,Junior Cesar Ferreira,Daniel Furtado Acuña-Guzman,Salvador Francisco Silva,Marx Leandro Naves Pires,Fábio Ribeiro Curi,Nilton

Initial Energy for External Electrical Cardioversion of Atrial Fibrillation

OBJECTIVE - To investigate the initial energy level required for electrical cardioversion of atrial fibrillation (AF). METHODS - We studied patients undergoing electrical cardioversion in the 1st Multicenter Trial of SOCESP. Patients were divided into 2 groups according to the initial energy level of electrical cardioversion: 100J and > or = 150J. We compared the efficacy of the initial and final shock of the procedure, the number of shocks administered, and the cumulative energy levels. RESULTS - Eight-six patients underwent electrical cardioversion. In 53 patients (62%), cardioversion was started with 100J, and in 33 patients (38%), cardioversion was started with > or = 150J. Groups did not differ regarding clinical features and therapeutical interventions. A tendency existed towards greater efficacy of the initial shock in patients who received > or = 150J (61% vs. 42% in the 100J group, p=0.08). The number of shocks was smaller in the > or = 150J group (1.5±0.7 vs. 2.1±1.3, p=0.04). No difference existed regarding the final efficacy of electrical cardioversion and total cumulative energy levels in both groups. In the subgroup of patients with recent-onset AF (<=48h), the cumulative energy level was lower in the 100J group (240±227J vs. 324±225J, p=0.03). CONCLUSION - Patients who were given initial energy of > or = 150J received fewer counter shocks with a tendency toward greater success than those patients who were given 100J; however, in patients with recent-onset AF, the average cumulative energy level was lower in the 100J group. These data suggest that electrical cardioversion should be initiated with energy levels > or = 150J in patients with chronic AF.

Ano

2002

Creators

Figueiredo,Edilberto Veloso,Henrique Horta Paola,Angelo Amato Vincenzo de

Eficiência dos Ésteres de Fitoesteróis Alimentares na Redução dos Lípides Plasmáticos em Hipercolesterolêmicos Moderados

OBJETIVO - Avaliar o efeito dos ésteres de fitoesteróis (FE) da dieta, em função dos diferentes genótipos de apo E, sobre os lípides plasmáticos em indivíduos moderadamente hipercolesterolêmicos. MÉTODOS - Pacientes moderadamente hipercolesterolêmicos (20 a 60 anos de idade; 50 mulheres e 10 homens), mantidos em dieta habitual, receberam margarina (20g/dia) enriquecida com fitoesteróis (2,8g/dia=1,68g de FE), ou margarina normal (placebo), por dois períodos de quatro semanas cada, em estudo duplo cego e cruzado. RESULTADOS - Fitoesteróis reduziram significativamente o colesterol total e o LDL-colesterol, respectivamente, em 10% e 12% quando comparado à fase basal de admissão ao programa, e 6% e 8% quando comparado à fase placebo. O HDL-colesterol e a trigliceridemia não se modificaram. CONCLUSÃO - Ésteres de fitoesteróis da dieta reduziram a colesterolemia e a redução do LDL-colesterol foi mais pronunciada nos indivíduos que apresentavam valores maiores de LDL-colesterol, quando admitidos no estudo. Em relação ao sinótipo de apo E não houve diferença significativa entre apo E 3/3 e apo E 3/4.

Ano

2002

Creators

Lottenberg,Ana M. P. Nunes,Valéria S. Nakandakare,Edna R. Neves,Mônica Bernik,Márcia Santos,José E. Quintão,Eder C. R.

QRS Voltage-Duration Product in the Identification of Left Ventricular Hypertrophy in Spontaneously Hypertensive Rats

OBJECTIVE - Evaluation of the performance of the QRS voltage-duration product (VDP) for detection of left ventricular hypertrophy (LVH) in spontaneously hypertensive rats (SHR). METHODS - Orthogonal electrocardiograms (ECG) were recorded in male SHR at the age of 12 and 20 weeks, when systolic blood pressure (sBP) reached the average values of 165±3 mmHg and 195±12 mmHg, respectively. Age- and sex- matched normotensive Wistar Kyoto (WKY) rats were used as controls. VDP was calculated as a product of maximum QRS spatial vector magnitude and QRS duration. Left ventricular mass (LVM) was weighed after rats were sacrificed. RESULTS - LVM in SHR at 12 and 20 weeks of age (0.86±0.05 g and 1.05±0.07 g, respectively) was significantly higher as compared with that in WKY (0.65±0.07 g and 0.70±0.02 g). The increase in LVM closely correlated with the sBP increase. VDP did not reflect the increase in LVM in SHR. VDP was lower in SHR as compared with that in WKY, and the difference was significant at the age of 20 weeks (18.2mVms compared with 10.7mVms, p<0.01). On the contrary, a significant increase in the VDP was observed in the control WKY at the age of 20 weeks without changes in LVM. The changes in VDP were influenced mainly by the changes in QRSmax. CONCLUSION - LVM was not the major determinant of QRS voltage changes and consequently of the VDP. These data point to the importance of the nonspatial determinants of the recorded QRS voltage in terms of the solid angle theory.

Ano

2002

Creators

Bacharova,Ljuba Kyselovic,Jan Klimas,Jan

Electrocardiographic and Blood Pressure Alterations During Electroconvulsive Therapy in Young Adults

OBJECTIVE - To study cardiovascular alterations in young patients with no apparent organic disease who underwent electroconvulsive therapy. METHODS - The study comprised 47 healthy patients (22 males and 25 females) with a mean age of 30.3 years, who underwent electroconvulsive therapy. Ambulatory blood pressure monitoring and continuous electrocardiographic monitoring (Holter monitor) were performed during 24 hours. Blood pressure and heart rate were assessed 4 hours prior to electric shock administration, during electric shock administration, and 3 hours after electric shock administration. Arrhythmias and alterations in the ST segment in 24 hours were recorded. RESULTS - On electroconvulsive therapy, a significant increase in blood pressure and heart rate was observed and the measurements returned to basal values after 25 minutes. Three females had tracings with depression of the ST segment suggesting myocardial ischemia prior to and after electroconvulsive therapy. Coronary angiography was normal. No severe cardiac arrhythmias were diagnosed. CONCLUSION - 1) Electroconvulsive therapy is a safe therapeutic modality in psychiatry; 2) it causes a significant increase in blood pressure and heart rate; 3) it may be associated with myocardial ischemia in the absence of coronary obstructive disease; 4) electroconvulsive therapy was not associated with the occurrence of severe cardiac arrhythmias.

Ano

2002

Creators

Rumi,Demetrio Ortega Solimene,Maria Cecília Takada,Júlio Yoshio Grupi,César José Giorgi,Dante Marcelo Rigonatti,Sérgio Paulo Luz,Protásio Lemos da Ramires,José Antonio Franchini

Analysis of Plasma Homocysteine Levels in Patients with Unstable Angina

OBJECTIVE - To determine the prevalence of hyperhomocystinemia in patients with acute ischemic syndrome of the unstable angina type. METHODS - We prospectively studied 46 patients (24 females) with unstable angina and 46 control patients (19 males), paired by sex and age, blinded to the laboratory data. Details of diets, smoking habits, medication used, body mass index, and the presence of hypertension and diabetes were recorded, as were plasma lipid and glucose levels, C-reactive protein, and lipoperoxidation in all participants. Patients with renal disease were excluded. Plasma homocysteine was estimated using high-pressure liquid chromatography. RESULTS - Plasma homocysteine levels were significantly higher in the group of patients with unstable angina (12.7±6.7 µmol/L) than in the control group (8.7±4.4 µmol/L) (p<0.05). Among males, homocystinemia was higher in the group with unstable angina than in the control group, but this difference was not statistically significant (14.1±5.9 µmol/L versus 11.9±4.2 µmol/L). Among females, however, a statistically significant difference was observed between the 2 groups: 11.0±7.4 µmol/L versus 6.4±2.9 µmol/L (p<0.05) in the unstable angina and control groups, respectively. Approximately 24% of the patients had unstable angina at homocysteine levels above 15 µmol/L. CONCLUSION - High homocysteine levels seem to be a relevant prevalent factor in the population with unstable angina, particularly among females.

Ano

2002

Creators

Tavares,José Roberto D'Almeida,Vânia Diniz,Daniela C. Terzi,Carolina A. Cruz,Edison N. Stefanini,Edson Andriollo,Adagmar Paola,Angelo A.V. de Carvalho,Antonio C.

Arterial Hypertension in a Child with Williams-Beuren Syndrome (7q11.23 Chromosomal Deletion)

We report the case of a 7-year-old male child diagnosed with Williams-Beuren syndrome and arterial hypertension refractory to clinical treatment. The diagnosis was confirmed by genetic study. Narrowing of the descending aorta and stenosis of the renal arteries were also diagnosed. Systemic vascular alterations caused by deletion of the elastin gene may occur early in individuals with Williams-Beuren syndrome, leading to the clinical manifestation of systemic arterial hypertension refractory to drug treatment.

Ano

2002

Creators

Sylos,Cristina de Pereira,Alexandre C. Azeka,Estela Miura,Nana Mesquita,Sônia Maria Ferreira Ebaid,Munir

Internal Mammary to Pulmonary Artery Fistula Presenting as Early Recurrent Angina after Coronary Bypass

A 50-year-old man developed recurrent angina 1 year after coronary artery bypass surgery. The patient was found to have a large fistula involving branches of the internal mammary artery graft and the left pulmonary artery. In the absence of another clear cause for the patient's symptoms, we speculated that our patient's angina and abnormal stress nuclear study were due to coronary steal. In patients with a history of coronary bypass grafting, fistula formation between graft and native vessels should be considered as a possible cause of early recurrent angina.

Ano

2002

Creators

Ferreira,Alexandre C. Marchena,Eduardo de Liester,Michelle Sangosanya,Afolabi O.

Retinal Detachment in Preeclampsia

Preeclampsia is an obstetric disease of unknown cause that affects approximately 5% of pregnant women. The visual system may be affected with variable intensity, being the retinal detachment a rare complication. The retinal detachment in preeclampsia is usually bilateral and serous, and its pathogenesis is related to the choroidal ischemia secondary to an intense arteriolar vasospasm. The majority of patients have complete recovery of vision with clinical management, and surgery is unnecessary. This is a case report of a 27 year old patient who developed the severe form of preeclampsia on her first pregnancy. She had progressive blurred vision, until she could see only shadows. Ophthalmic examination diagnosed spread and bilateral retinal detachment. With blood pressure control at postpartum, the patient had her retina reattached, and recovery of vision.

Ano

2002

Creators

Prado,Renata Silva do Figueiredo,Estêvão Lanna Magalhães,Télcia Vasconcelos Barros

Myocardial Bridges and their Relationship to the Anterior Interventricular Branch of the Left Coronary Artery

OBJECTIVE: To analyze the relationship between myocardial bridges and the anterior interventricular branch (anterior descending) of the left coronary artery. METHODS: The study was carried out with postmortem material, and methods of dissection and observation were used. We assessed the perimeter of the anterior interventricular branch of the left coronary artery using a pachymeter, calculated its proximal and distal diameters in relation to the myocardial bridge, and also its diameter under the myocardial bridge in 30 hearts. We also observed the position of the myocardial bridge in relation to the origin of the anterior interventricular branch. RESULTS: The diameters of the anterior interventricular branch were as follows: the mean proximal diameter was 2.76±0.76 mm; the mean diameter under the myocardial bridge was 2.08±0.54 mm; and the mean distal diameter was 1.98±0.59 mm. In 33.33% (10/30) of the cases, the diameter of the anterior interventricular branch under the myocardial bridge was lower than the diameter of the anterior interventricular branch distal to the myocardial bridge. In 3.33% (1/30) of the cases, an atherosclerotic plaque was found in the segment under the myocardial bridge. The myocardial bridge was located in the middle third of the anterior interventricular branch in 86.66% (26/30) of the cases. CONCLUSION: Myocardial bridges are more frequently found in the middle third of the anterior interventricular branch of the left coronary artery. The diameter of the anterior interventricular branch of the left coronary artery under the myocardial bridge may be smaller than after the bridge. Myocardial bridges may not provide protection against the formation of atherosclerotic plaque inside the anterior interventricular branch of the left coronary artery.

Ano

2002

Creators

Lima,Vanildo Júnior de Melo Cavalcanti,Jennecy Sales Tashiro,Tetsuo

Experimental Model of Gene Transfection in Healthy Canine Myocardium: Perspectives of Gene Therapy for Ischemic Heart Disease

OBJECTIVE: To assess the transfection of the gene that encodes green fluorescent protein (GFP) through direct intramyocardial injection. METHODS: The pREGFP plasmid vector was used. The EGFP gene was inserted downstream from the constitutive promoter of the Rous sarcoma virus. Five male dogs were used (mean weight 13.5 kg), in which 0.5 mL of saline solution (n=1) or 0.5 mL of plasmid solution containing 0.5 µg of pREGFP/dog (n=4) were injected into the myocardium of the left ventricular lateral wall. The dogs were euthanized 1 week later, and cardiac biopsies were obtained. RESULTS: Fluorescence microscopy showed differences between the cells transfected and not transfected with pREGFP plasmid. Mild fluorescence was observed in the cardiac fibers that received saline solution; however, the myocardial cells transfected with pREGFP had overt EGFP expression. CONCLUSION: Transfection with the EGFP gene in healthy canine myocardium was effective. The reproduction of this efficacy using vascular endothelial growth factor (VEGF) instead of EGFP aims at developing gene therapy for ischemic heart disease.

Ano

2002

Creators

Kalil,Renato A. K. Teixeira,Leonardo A. K. Mastalir,Eduardo T. Moreno,Paulo Fricke,Cecília H. Nardi,Nance B.

Unsupervised Rehabilitation: effects of Exercise Training over the Long Run

OBJECTIVE: To assess the safety and efficacy of unsupervised rehabilitation (USR) in the long run in low-risk patients with coronary artery disease. METHODS: We carried out a retrospective study with 30 patients divided into: group I (GI) - 15 patients from private clinics undergoing unsupervised rehabilitation; group II (GII) - control group, 15 patients from ambulatory clinic basis, paired by age, sex, and clinical findings. GI was stimulated to exercise under indirect supervision (jogging, treadmill, and sports). GII received the usual clinical treatment. RESULTS: The pre- and postobservation values in GI were, respectively: VO2peak (mL/kg/min), 24±5 and 31± 9; VO2 peak/peak HR: 0.18±0.05 and 0.28±0.13; peak double product (DP peak):26,800±7,000 and 29,000 ± 6,500; % peak HR/predicted HRmax: 89.5±9 and 89.3±9. The pre- and post- values in GII were: VO2 peak (mL/kg/min), 27± 7 and 28±5; VO2 peak/peak HR: 0.2±0.06 and 0.2± 0.05; DP peak: 24,900±8,000 and 25,600± 8,000, and % peak HR/predicted HRmax: 91.3±9 and 91.1± 11. The following values were significant: preobservation VO2peak versus postobservation VO2peak in GI (p=0.0 063); postobservation VO2peak in GI versus postobservation VO2peak in GII (p=0.0045); postobservation VO2 peak/peak HR GI versus postobservation peak VO2/peak HR in GII (p=0.0000). The follow-up periods in GI and GII were, respectively, 41.33± 20.19 months and 20.60±8.16 months (p<0.05). No difference between the groups was observed in coronary risk factors, therapeutic management, or evolution of ischemia. No cardiovascular events secondary to USR were observed in 620 patient-months. CONCLUSION: USR was safe and efficient, in low-risk patients with coronary artery disease and provided benefits at the peripheral level.

Ano

2002

Creators

Oliveira Filho,Japy Angelini Leal,Ana Cristina Lima,Valter Correia Santos Filho,Dirceu Vieira Luna Filho,Bráulio

Neonate Aortic Stenosis: Importance of Myocardial Perfusion in Prognosis

OBJECTIVE: To analyze our experience with percutaneous aortic balloon valvuloplasty in newborn infants with aortic stenosis, emphasizing the extraordinary importance of myocardial perfusion.METHODS: Over a 10-year-period, 21 neonates underwent percutaneous aortic balloon valvuloplasty. Age ranged from 2 to 27 days, weight ranged from 2.2 to 4.1 kg and 19 were males. All patients presented with congestive heart failure that could not be treated clinically. The onset of symptoms in the first week of life occurred in 9 patients considered as having critical aortic stenosis. Severe aortic stenosis occurred in 12 patients with the onset of symptoms in the second week of life.RESULTS: Mortality reached 100% in the patients with critical aortic stenosis. The procedure was considered effective in the 12 patients with severe aortic stenosis. Vascular complications included the loss of pulse in 12 patients and rupture of the femoral artery in 2 patients. Cardiac complications included acute aortic regurgitation in 2 patients and myocardial perforation in one. In an 8.2<FONT FACE=Symbol>±</FONT>1.3-year follow-up, 5 of the 12 patients died (2 patients due to septicemia and 3 patients due to congestive heart failure). Five of the other 7 patients underwent a new procedure and 2 required surgery.CONCLUSION: Percutaneous aortic valvuloplasty in neonates is not an effective procedure in the 1st week of life, because at this age the common presentation is cardiogenic shock. It is possible that, in those patients with critical aortic stenosis, dilation of the aortic valve during fetal life may change the prognosis of its clinical outcome.

Ano

2002

Creators

Santos,Marco Aurélio Azevedo,Vitor Manuel Pereira