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Biomedical subjects

J Azevedo

Publications and source records attributed to J Azevedo.

At least 19 recordsLinked to original sources

Evaluation of the passive particle agglutination test in the serodiagnosis and follow-up of syphilis.

We performed the present study to determine the rate of concordance of the fluorescent treponemal antibody absorption test (FTA-ABS) and of the microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP) with the passive particle agglutination test (TP.PA) in patients with early syphilis and to observe the reactivity of the rapid plasma reagin (RPR), MHA-TP, and the TP.PA tests for 1 year after therapy. The study included 449 people who were given therapy if they had syphilis and followed up for 1 year. The rate of concordance of the TP.PA with the MHA-TP was 98.4%, and it was 98.9% with the FTA-ABS. During follow-up, a significant decrease of antibodies was found in 56%, 26%, and 70% of the patients when using the RPR, the MHA-TP, and the TP.PA, respectively. The TP.PA seems to be an adequate routine assay for the diagnosis of syphilis, being as sensitive as the FTA-ABS test in primary syphilis and as useful as the RPR test in monitoring therapy.

Agglutination Tests↗

Doppler tissue imaging.

This paper try to give a general overview of the main areas of DTI clinical application, its main technical limitations, new directions still under investigation and some potential future developments of this emerging imaging technique. In this review article we pretend to discuss the main aspects of the new DTI method, its present "state of the art" and future perspectives of scientific and technical development.

Diastole↗

Current status of three-dimensional echocardiography.

Volume rendered three-dimensional echocardiography (3DE), a rapidly emerging imaging method, offers clinicians and surgeons a new perspective for visualizing the heart. Using both transthoracic and transesophageal approach this new methodology enables qualitative and quantitative information of cardiac disorders to be obtained. 3DE image projections have allowed visualization of intracardiac structures and great vessels and delineation of their pathology in a comprehensive manner. Experimental and clinical studies suggest that 3DE is likely to play a valuable role in the evaluation of various cardiac and flow disorders and in planning interventions and surgery. In addition, 3DE has been applied to derive quantitative measurements of volume, mass and dimensions of the left and right ventricles and also other cardiac lesions, such as atrial and ventricular septal defects. Every aspect of 3DE is in continuous evolution. Faster and more highly automated image processing could make the technique more easily applicable in the clinical scenario.

Echocardiography, Three-Dimensional↗

Myocardial architecture, texture and left ventricular heterogeneity in the pulsed Doppler tissue imaging pattern.

The regional contribution for the global ventricular functional performance is complex and heterogeneous, the myocardial texture could reflect this particular aspect, during the phases of myocardial contraction and relaxation. The objective of our clinical study was to evaluate the relationship between the segmental myocardial velocity pattern by Doppler tissue imaging and the ultrasound characteristics of the left ventricular myocardium analysed by computerized ultrasound densitometry with the calculation of its intensity (dB), in a population of 22 subjects without clinical history of cardiovascular pathology, 50% female gender, mean age 43 +/- 11 years (19-66 years). In the methodology of study, the left ventricular myocardium was divided in 16 segments, according with the transthoracic echocardiographic recommendations of the American Society of Echocardiography (A.S.E.). During one cardiac cycle interval, the ultrasound characteristics of the left ventricular myocardium were evaluated continuously and in a quantitative manner, applying the computerized ultrasound densitometry method on the gray scale images of the ventricular myocardium, with the sample size identical to the myocardial wall thickness. The peak (Vmax-cm/sec) and mean (Vm-cm/sec) pulsed Doppler tissue imaging velocities, individuals, segmental and a total velocities, contraction and relaxation velocities of the left ventricular myocardium were obtained immediately after the computerized ultrasound densitometry analysis. Ultrasound densitometry and Doppler tissue imaging data were obtained in a total number of 352 left ventricular myocardial segments. Using the multiple linear correlation matrix analysis, the ultrasound intensity registered inverse significant correlation's with the Doppler tissue imaging Vmax and Vm for the systolic "s" wave in the total segments and each one of them (r = -0.66; p = 0.001; interval 2-18 cm/sec; r = -0.52 to -0.70) and with the early diastolic "e" wave (r = -0.42; p = 0.01; interval 2-19 cm/sec; r = -0.35 to -0.55). Direct correlation's were obtained for the computerized ultrasound densitometry intensity and Doppler tissue imaging Vmax and Vm of the late diastolic "a" wave in the total number of the left ventricular myocardial wall segments and in each one of them (r = 0.51; p = 0.01; interval 1-17 cm/sec; r = 0.42 a 0.66). We conclude that in our study and under physiological conditions of myocardial performance, a direct correlation was obtained between the ultrasound characteristics of the ventricular myocardial imaging and its velocities of contraction and relaxation. These facts reflect the close relationship between left ventricular myocardial structure and function, analyzed by the new ultrasound Doppler technologies.

Adult↗

Importance of lipoprotein metabolism parameters in the clinical and angiographic severity of coronary artery disease.

Coronary artery disease that is clinically and angiographically significant is associated to important biochemical parameters with direct interference in lipoprotein and apoprotein metabolism. The purpose of our study was to evaluate the importance of several lipoprotein metabolic parameters in the clinical and angiographic severity of chronic coronary artery disease. In a population with the diagnosis of ischemic coronary artery disease, we assessed the degree of angiographic (single- versus multivessel disease) and clinical (C.C.S. I-IV classification) severities. In each patient, we determined the value of total cholesterol, triglycerides, HDL and LDL cholesterol, HDL 2 and 3, apoprotein AI and B, lipoprotein (a), anti-phospholipid antibodies and C reactive protein. Our results showed that some parameters were significant in the comparison between a normal group and the global coronary artery disease population, such as the value of total cholesterol, HDL cholesterol, HDL 2, apoprotein AI and B lipoprotein (a) and anti-phospholipid antibodies. In the distinction of coronary artery disease subgroups, in relation to C.C.S. < or = 2 and > or = 3 classes, some factors could be discriminated, such as HDL cholesterol, HDL 2, total cholesterol/HDL, lipoprotein (a), anti-phospholipid antibodies and C reactive protein. In the distinction between classes C.C.S. < or = 2 and AMI, the levels of triglycerides, HDL cholesterol, HDL 2, total cholesterol/HDL, lipoprotein (a) and anti-phospholipid antibodies were significant. In the division between single vessel versus multivessel coronary artery disease we found significant values of HDL cholesterol, HDL 2, total cholesterol/HDL, apoprotein AI, lipoprotein (a), anti-phospholipid antibodies and C reactive protein. In conclusion, our present study endorses the clinical role of lipids and plasma lipoproteins in the determination of several cardiovascular risk factors, but introduction of new parameters such as lipoprotein (a) and the anti-phospholipid antibodies can be very useful for a better and global understanding of the pathophysiological processes and distinction of higher risk subgroups for extension and degree of severity of ischemic coronary artery disease.

Aged↗

Regional diastolic function in ischaemic heart disease using pulsed wave Doppler tissue imaging.

AIMS: The aim of this study was to determine the utility of pulsed wave Doppler tissue imaging in the evaluation of regional left ventricular diastolic function in patients with ischaemic heart disease. METHODS AND RESULTS: In 30 normal subjects and 43 patients with ischaemic heart disease, Doppler tissue imaging was performed in each of the 16 segments of the myocardium. The following diastolic pulsed wave Doppler tissue imaging parameters were obtained for each segment: (1) regional early diastolic peak velocity (regional e wave cm.s-1); (2) regional late diastolic peak velocity (regional a wave cm.s-1); (3) regional diastolic e/a velocity ratio; and (4) the regional isovolumic relaxation time, defined as the time interval from the second heart sound to the onset of the diastolic E wave. In patients with ischaemic heart disease, each of these parameters was evaluated and compared in ischaemic and normally perfused segments, based on the presence or absence of obstructive lesions of the supplying coronary artery. In patients with coronary artery disease, several differences were observed between diseased and normal wall segments: the mean segmental peak early diastolic velocity (e wave) was reduced (mean +/- SD: 6.4 +/- 2.1 cm.s-1 vs 8.5 +/- 2.8 cm.s-1; P < 0.01); the e/a diastolic velocity ratio was decreased (0.95 +/- 0.3 vs 1.5 +/- 0.6, respectively; P < 0.01) and the regional isovolumic relaxation time was prolonged (104 +/- 36.7 ms vs 69.6 +/- 30 ms; P < 0.01. No differences were observed in any of these parameters between the normally perfused segments of ischaemic patients and normal subjects. Patients with a normal transmitral diastolic Doppler inflow pattern had a mean of 3.7 +/- 2.7 myocardial segments with a local e/a pulsed wave Doppler tissue imaging velocity ratio < 1, fewer than those with an inverted diastolic transmitral Doppler inflow pattern (10.3 +/- 3 segments; P < 0.001). Overall sensitivity and specificity for an inverted local e/a ratio and a local isovolumetric relaxation time > or = 85 ms were of 62% and 72% and 69% and 80%, respectively. CONCLUSION: Regional diastolic wall motion is impaired at baseline in ischaemic myocardial segments, even when systolic contraction is preserved. Pulsed wave Doppler tissue imaging is a useful non-invasive technique which allows the assessment of regional diastolic performance and dynamics of the left ventricular myocardium. Further studies are required to define this role in the evaluation of coronary heart disease.

Blood Flow Velocity↗

[A histological analysis of the changes experimentally induced by cadmium in cardiac muscle tissue by a computerized method of image analysis].

OBJECTIVE: To study the distribution of myocardial structural elements in a univentricular experimental model (Halobatrachus didactylus) and the changes induced by acute exposure to a sublethal concentrations of cadmium. DESIGN: 15 specimens of H. didactylus (marine teleost) were divided in three groups: CTRL: the control group, the fish were injected with a saline solution; 24 H: 1 mg/kg of cadmium chloride was injected and fish were sacrificed after 1 day post injection; 7 D: fish where subjected to the same cadmium concentration and sacrificed after 7 days post injection. INTERVENTIONS: Histological sections (5 microns) of ventricle were coloured by PicroSirius method and used to determine the fraction area occupied by the several myocardium structural elements, using specific software Optimas Bioscan 5.2. MEASUREMENTS AND RESULTS: The different structural elements of H. didactylus myocardium displayed in different ways and its distribution along the ventricular wall remained unchanged on exposure to cadmium. The structural elements of H. didactylus myocardium showed a characteristic pattern: collagen type I revealed a heterogeneous distribution, with fractional area values greater in epicardial and endocardial layers; collagen type III, has a homogeneous distribution with the myocardial wall thickness with lesser fractional area values than collagen I; cardiac muscle tissue showed a tendency to occupy a greater fractional area in the epicardial-endocardial region. Cadmium toxicity resulted in an increase in the fractional area occupied by muscle tissue to the detriment of the area occupied by the intertrabecular spaces (lacunae), with no alterations in the other structural components. CONCLUSIONS: On our H. didactylus fish model, cadmium may have induced a myocardial edema which resulted in an increase in the fractional area occupied by muscle tissue, with no alterations in other structural components of the myocardium or in the relative ventricular mass.

Animals↗

[Cadmium and cardiac muscle cell - biomarkers of oxidative stress - experimental work].

OBJECTIVE: To study in several tissues (heart, kidney and liver) of Halobatrachus didactylus the cellular response induced by an acute exposure to a sublethal cadmium concentration. DESIGN: Fifteen species of H. didactylus (marine teleost) were divided in to three groups: CTRL: control group, the fish were injected with a saline solution; 24 H: 1 mg/kg of cadmium chloride was injected and the fish were sacrificed after 24 hours; 7 D: the fish were subjected to the same cadmium concentration and sacrificed 7 days after injection. INTERVENTIONS: Superoxide dismutase--SOD (McCord & Fridovich, 1969) and catalase--CAT (Clairborne, 1985) activities were determined in the cytosolic and mitochondrial fractions of these three tissues. The lipid degradation products were also determined by the tiobarbithuric acid (TBA) test. MEASUREMENTS AND RESULTS: Cadmium induced an increase in SOD activity in both fractions (cytosolic and mitochondrial) of these H. didactylus tissues. The highest levels of activity observed were located at mitochondrial fraction and in the heart. There was a significant increase in CAT activity in both liver and heart tissue fractions after cadmium exposure. The highest values were observed in the liver. The kidney presented a different response: there was a rise in CAT activity only in the mitochondrial fraction after seven days of exposure. There were no significant changes in lipid degradation products in any of these tissues after cadmium exposure. CONCLUSIONS: The two antioxidant enzymes studied in the heart, kidney and liver of H. didactylus demonstrated a high sensitivity to oxidative stress induced by cadmium and presented a high potential as cellular biological makers. The results indicate membrane lesion caused by lipid peroxidation did not occur, which suggests an efficient response of the cellular protection mechanisms against cadmium cytotoxicity.

Animals↗