Apesar dos múltiplos avanços na compreensão gênica e taxonômica do Paramixovírus de serpentes (OPMV), apenas a patogenia pulmonar é razoavelmente conhecida nos viperídeos. O objetivo do presente estudo foi investigar, através de exames anátomo-patológicos, imunoistoquímicos, microbiológicos, hematológicos e sorológicos, a patogenia do Paramixovírus em jibóias (Boa constrictor). Dez animais foram inoculados por via endotraqueal com uma suspensão viral de OPMV. Os animais foram submetidos à eutanásia aos pares, aos 3, 7, 14, 21 e 60 dias após a infecção. Dois indivíduos foram utilizados como controle negativo. Lavados traqueais e amostras de sangue foram colhidas antes da inoculação, às necrópsias e nos animais dos grupos remanescentes. A presença de anticorpos anti-OPMV foi detectada aos 2 mPI através da técnica de inibição de hemaglutinação. A análise estatística dos resultados hematológicos demonstrou não haver diferença significativa entre os dados obtidos nos diversos tempos. À necrópsia amostras de órgãos foram colhidos para análises histopatológica, imunoistoquímica, bacteriológica e virológica (isolamento e RT-PCR). Macroscopicamente, apenas um animal (7dPI) apresentou pneumonia piogranulomatosa. As principais lesões microscópicas pulmonares observadas foram infiltração granulocítica, associada à formação de ninhos de células mononucleares, formação de sincícios; presença de hiperplasia e hipertrofia epiteliais em todos os tempos experimentais. Em pâncreas pôde ser diagnosticada formação de sincícios e presença de infiltrado mononuclear; em baço foi observada histiocitose, eventualmente associada à infiltração granulocítica perifolicular; gliose de padrão difuso ou focal. Os ensaios imunoistoquímicos e isolamento viral, com confirmação da presença do OPMV por RT-PCR, foram positivos em pulmão, fígado, baço e pâncreas dos 3 aos 21 dPI, sendo negativos aos 60 pPI. O diagnóstico molecular de lavado traqueal após passagem em cultura celular foram positivos aos 3, 7, 14 e 21d PI.. A ausência de sinais clínicos associada à detecção de lesões, isolamento e diagnóstico positivo por RT- PCR sugerem que as jibóias podem representar uma importante fonte assintomática de infecção até os 21 d PI. / Despite multiple advances in the genetic and taxonomic understanding of ophidian paramyxovirus (OPMV), only pulmonary pathogenesis is reasonably known in viperids. The objective of the present study was to investigate the pathogenesis of paramyxovirus infection in Boidae by pathological, imunohistochemical, microbiological, hematological and serological studies. Ten Boa constrictor snakes were infected by endotracheal inoculation with a viral solution. The animals were euthanatized in pairs at 3, 7, 14 and 21 days and at 2 months after infection. Two uninfected boas were sacrificed before and after the experimental study and were used as negative controls. Tracheal washes and blood were collected from all snakes. Seroconversion was detected at 2 mPI by hemagglutination inhibition assays. Estatistical analysis of the hematological data by Friedman Test revealed no diferences between them. At necropsy, samples of all major organs were obtained for histopathological, immunohistochemical, bacteriological and virological (viral isolation and RT-PCR). At necropsy, only one snake (7 days PI) had gross changes in the lung. The most consistent microscopic findings in the lungs were granulocyte infiltration, associated with the formation of mononuclear cell nests, formation of syncytia, and presence of epithelial hyperplasia and hypertrophy. Formation of syncytia was observed in pancreas, a mononuclear infiltrate was also observed; splenic histiocytosis with perifollicular granulocyte infiltration; diffuse and focal pattern of gliosis was detected in the CNS of most of the animals. Immunohistochemical examination and viral isolation, with confirmation of the virus\' presence by RT-PCR, were positive for lung, liver, spleen and pancreas from 3 to 21 dPI and negative at 2 m PI. Virus isolation from tracheal washes, with confirmation by molecular diagnosis were positive at times 3, 7, 14 and 21 dPI. At 2 mPI all results were negative. The immunohistochemical results associated with virus isolation and RT-PCR suggest that the virus was probably eliminated from the organism at 2 mPI. The absence of clinical symptoms associated with the detection of lesions and with isolation and a positive diagnosis by PCR in the present study suggest that Boa constrictors may represent an important source of infection for other reptiles.

Apesar dos múltiplos avanços na compreensão gênica e taxonômica do Paramixovírus de serpentes (OPMV), apenas a patogenia pulmonar é razoavelmente conhecida nos viperídeos. O objetivo do presente estudo foi investigar, através de exames anátomo-patológicos, imunoistoquímicos, microbiológicos, hematológicos e sorológicos, a patogenia do Paramixovírus em jibóias (Boa constrictor). Dez animais foram inoculados por via endotraqueal com uma suspensão viral de OPMV. Os animais foram submetidos à eutanásia aos pares, aos 3, 7, 14, 21 e 60 dias após a infecção. Dois indivíduos foram utilizados como controle negativo. Lavados traqueais e amostras de sangue foram colhidas antes da inoculação, às necrópsias e nos animais dos grupos remanescentes. A presença de anticorpos anti-OPMV foi detectada aos 2 mPI através da técnica de inibição de hemaglutinação. A análise estatística dos resultados hematológicos demonstrou não haver diferença significativa entre os dados obtidos nos diversos tempos. À necrópsia amostras de órgãos foram colhidos para análises histopatológica, imunoistoquímica, bacteriológica e virológica (isolamento e RT-PCR). Macroscopicamente, apenas um animal (7dPI) apresentou pneumonia piogranulomatosa. As principais lesões microscópicas pulmonares observadas foram infiltração granulocítica, associada à formação de ninhos de células mononucleares, formação de sincícios; presença de hiperplasia e hipertrofia epiteliais em todos os tempos experimentais. Em pâncreas pôde ser diagnosticada formação de sincícios e presença de infiltrado mononuclear; em baço foi observada histiocitose, eventualmente associada à infiltração granulocítica perifolicular; gliose de padrão difuso ou focal. Os ensaios imunoistoquímicos e isolamento viral, com confirmação da presença do OPMV por RT-PCR, foram positivos em pulmão, fígado, baço e pâncreas dos 3 aos 21 dPI, sendo negativos aos 60 pPI. O diagnóstico molecular de lavado traqueal após passagem em cultura celular foram positivos aos 3, 7, 14 e 21d PI.. A ausência de sinais clínicos associada à detecção de lesões, isolamento e diagnóstico positivo por RT- PCR sugerem que as jibóias podem representar uma importante fonte assintomática de infecção até os 21 d PI. / Despite multiple advances in the genetic and taxonomic understanding of ophidian paramyxovirus (OPMV), only pulmonary pathogenesis is reasonably known in viperids. The objective of the present study was to investigate the pathogenesis of paramyxovirus infection in Boidae by pathological, imunohistochemical, microbiological, hematological and serological studies. Ten Boa constrictor snakes were infected by endotracheal inoculation with a viral solution. The animals were euthanatized in pairs at 3, 7, 14 and 21 days and at 2 months after infection. Two uninfected boas were sacrificed before and after the experimental study and were used as negative controls. Tracheal washes and blood were collected from all snakes. Seroconversion was detected at 2 mPI by hemagglutination inhibition assays. Estatistical analysis of the hematological data by Friedman Test revealed no diferences between them. At necropsy, samples of all major organs were obtained for histopathological, immunohistochemical, bacteriological and virological (viral isolation and RT-PCR). At necropsy, only one snake (7 days PI) had gross changes in the lung. The most consistent microscopic findings in the lungs were granulocyte infiltration, associated with the formation of mononuclear cell nests, formation of syncytia, and presence of epithelial hyperplasia and hypertrophy. Formation of syncytia was observed in pancreas, a mononuclear infiltrate was also observed; splenic histiocytosis with perifollicular granulocyte infiltration; diffuse and focal pattern of gliosis was detected in the CNS of most of the animals. Immunohistochemical examination and viral isolation, with confirmation of the virus\' presence by RT-PCR, were positive for lung, liver, spleen and pancreas from 3 to 21 dPI and negative at 2 m PI. Virus isolation from tracheal washes, with confirmation by molecular diagnosis were positive at times 3, 7, 14 and 21 dPI. At 2 mPI all results were negative. The immunohistochemical results associated with virus isolation and RT-PCR suggest that the virus was probably eliminated from the organism at 2 mPI. The absence of clinical symptoms associated with the detection of lesions and with isolation and a positive diagnosis by PCR in the present study suggest that Boa constrictors may represent an important source of infection for other reptiles.

Submitted by Socorro Pontes (socorrop@ufersa.edu.br) on 2017-05-12T12:16:29Z No. of bitstreams: 1 ThiagoGC_DISSERT.pdf: 3396774 bytes, checksum: f3817a3af241b189448e74cd442634c0 (MD5) / Made available in DSpace on 2017-05-12T12:16:30Z (GMT). No. of bitstreams: 1 ThiagoGC_DISSERT.pdf: 3396774 bytes, checksum: f3817a3af241b189448e74cd442634c0 (MD5) Previous issue date: 2016-11-30 / The jiboias (Boa constrictor) are tropical snakes that can present an average length of 3.5 m, occupying most of the Brazilian biomes. It is one of the most common snake species found in zoological collections in Brazil, being used as a tool for environmental and leisure education. The maintenance of these animals in captivity, associated with management errors, predisposes to the appearance of cutaneous lesions that, if not treated, can compromise the health and / or quality of life of these animals. Thus, the importance of identifying and developing the best agents for healing is hoped that they will be preferentially accessible and inexpensive, like some herbal medicines. This study followed the cicatrization of aloe vera, EB1 and EB2, gel and total leaf, respectively, in 12 jiboias (Boa constrictor), by means of macroscopic daily evaluations, for 40 consecutive days. Appearance of the wound in terms of color, gloss, crust formation and exudation. The obtained data evidenced differences in relation to the control group, demonstrating the effect of this phytotherapic on the cicatrisation / As jiboias (Boa constrictor) são serpentes tropicais que podem apresentar um comprimento médio de 3,5 m, ocupando a maioria dos biomas brasileiros. É uma das espécies de serpentes mais encontradas em coleções de zoológicos no Brasil, sendo utilizada como ferramenta de educação ambiental e lazer. A manutenção desses animais em cativeiro, associado a erros de manejo, predispõe ao aparecimento de lesões cutâneas que, se não forem tratadas, podem comprometer a saúde e/ou a qualidade de vida desses animais. Destaca-se assim, a importância de identificar e desenvolver os melhores agentes promotores da cicatrização, esperando que eles sejam preferencialmente de fácil acesso e baixo custo, como alguns fitoterápicos. Diante disso, este estudo acompanhou o efeito cicatrizante de extratos hidroalcóolicos da babosa (Aloe vera), EB1 e EB2, gel e folha total respectivamente, em 12 jiboias (Boa constrictor), através de avaliações macroscópicas diárias, durante 40 dias consecutivos, quanto ao aspecto da ferida em termos de cor, brilho, formação de crosta e exsudação, além de análises histológicas a cada 5 dias. Os dados obtidos evidenciaram diferenças em relação ao grupo controle, demostrando o efeito desse fitoterápico sobre a cicatrização / 2017-05-12

Vascular reactivity to vasopressin and phenylephrine is potentiated by constrictor prostanoids (CP) in normotensive female (F) but not male (M) rat aorta and CP function is estrogen-dependent. This study investigated the effects of estrogen on CP function and arterial blood pressure (MAP) during development of aortic coarctation-induced hypertension (HT). M and F rats, (15-18 wks.) in four groups: normotensive (NT), hypertensive (HT), ovariectomized (OVX), and OVX estrogen-replaced (OE), underwent abdominal aortic coarctation or sham surgery (NT). At 14 days, SQ 29,548 (SQ, Thromboxane A2 (TXA2) receptor antagonist) was given i.v. to the groups. In another experiment, rats received Ridogrel (TXA2 receptor antagonist+TXA2 synthase (TXS) inhibitor) or vehicle (methyl cellulose) daily, for 14 days. Thoracic aortae were analyzed for morphology, incubated in Kreb’s Henseleit Buffer (KHB) ± angiotensin II (ANG II), or underwent continuous pulsatile flow and pressure experiments (PFP) with KHB ± ANG II. Perfusate was analyzed for thromboxane B2 (TXB2) and prostaglandin F1α (PGF1α). RT-PCR and immunohistochemistry were performed for TXS. MAP was higher in F-HT than in M-HT after 14 days. SQ infusion reduced MAP substantially more in F-HT and OE-HT than in others. Ridogrel prevented increases in MAP in F/OE-HT rats, but not M/OVX-HT. Basal release of TXB2 and PGF1α increased to a greater extent in F-HT than in M-HT relative to their controls. ANG II-stimulated TXB2 and PGF1α release increased to a greater extent in F-HT than in M-HT. With or without ANG II, TXB2 production in HT during PFP increased with estrogen. PGF1α increased during PFP with estrogen, however not with ANG II. Pressurization resulted in less diameter change in F and OE-HT than in OVX-HT. Elastin increased with HT (inhibited by Ridogrel) in all but M. Collagen increased in HT with estrogen (inhibited by Ridogrel). Neither OVX-HT nor Ridogrel had any effect on morphology. Estrogen increased TXS with HT. Estrogen enhanced vascular CP and MAP in F-HT by increased expression of TXS and collagen density in the vasculature indicating that in aortic coarctation-induced HT, CP are upregulated by estrogen. Specific forms of HT in human beings may involve estrogen-induced vascular CP upregulation.

Vascular reactivity to vasopressin and phenylephrine is potentiated by constrictor prostanoids (CP) in normotensive female (F) but not male (M) rat aorta and CP function is estrogen-dependent. This study investigated the effects of estrogen on CP function and arterial blood pressure (MAP) during development of aortic coarctation-induced hypertension (HT). M and F rats, (15-18 wks.) in four groups: normotensive (NT), hypertensive (HT), ovariectomized (OVX), and OVX estrogen-replaced (OE), underwent abdominal aortic coarctation or sham surgery (NT). At 14 days, SQ 29,548 (SQ, Thromboxane A2 (TXA2) receptor antagonist) was given i.v. to the groups. In another experiment, rats received Ridogrel (TXA2 receptor antagonist+TXA2 synthase (TXS) inhibitor) or vehicle (methyl cellulose) daily, for 14 days. Thoracic aortae were analyzed for morphology, incubated in Kreb’s Henseleit Buffer (KHB) ± angiotensin II (ANG II), or underwent continuous pulsatile flow and pressure experiments (PFP) with KHB ± ANG II. Perfusate was analyzed for thromboxane B2 (TXB2) and prostaglandin F1α (PGF1α). RT-PCR and immunohistochemistry were performed for TXS. MAP was higher in F-HT than in M-HT after 14 days. SQ infusion reduced MAP substantially more in F-HT and OE-HT than in others. Ridogrel prevented increases in MAP in F/OE-HT rats, but not M/OVX-HT. Basal release of TXB2 and PGF1α increased to a greater extent in F-HT than in M-HT relative to their controls. ANG II-stimulated TXB2 and PGF1α release increased to a greater extent in F-HT than in M-HT. With or without ANG II, TXB2 production in HT during PFP increased with estrogen. PGF1α increased during PFP with estrogen, however not with ANG II. Pressurization resulted in less diameter change in F and OE-HT than in OVX-HT. Elastin increased with HT (inhibited by Ridogrel) in all but M. Collagen increased in HT with estrogen (inhibited by Ridogrel). Neither OVX-HT nor Ridogrel had any effect on morphology. Estrogen increased TXS with HT. Estrogen enhanced vascular CP and MAP in F-HT by increased expression of TXS and collagen density in the vasculature indicating that in aortic coarctation-induced HT, CP are upregulated by estrogen. Specific forms of HT in human beings may involve estrogen-induced vascular CP upregulation.

Made available in DSpace on 2015-04-22T22:12:39Z (GMT). No. of bitstreams: 1 Adriana Bentes Craveiro.pdf: 602357 bytes, checksum: 77958ee6f46ef6db5b7c27ff757670c8 (MD5) Previous issue date: 2013-06-24 / CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico / Currently almost 1/5 of the species of reptiles are endangered in the world. In this imminent scenario of biological loss, the rapid growth of human population and urban density are considered global threats to reptilian diversity by the destruction, modification and homogenization of the natural environment, far beyond the boundary of the municipality. In the urban landscape in expansion, snakes are among the reptiles impacted primarily due to their ecological and behavioral quirks, which often trigger fear in western human. Manaus, the most populous city of the Amazon biome, since the first decade of the XXI century has accelerated the expansion of the urban area in a disorderly manner on the surrounding continuous forest. Among vertebrates directly affected by this process of degradation of habitat is the jiboia (Boa constrictor). This snake, although it can reach up to 4.2 m in total length, can persist in modified environments and has been one of the vertebrates with the largest number of rescues by power public in Manaus in the last decade. Between 09/2010 and 11/2012 were evaluated 222 specimens of B. constrictor that were rescued in the urban area of the capital of Amazonas. The high frequency of individuals in basically all sizes / ages, of both sexes and distributed throughout the urban area of Manaus indicated that the capital of Amazonas still contains a robust population of B. constrictor. There wasn t relationship between the accumulated rainfall in the last 24 hours and the occurrence of rescues, indicating that the B. constrictor in Manaus aren t simply carried by heavy rain, which would favor its viewing by residents and triggering the rescue. On the contrary, the rescue rate appeared to reflect seasonal movement of the target species, and the monthly precipitation explained 45% of the variance in the number of B. constrictor rescued in the respective months. The sex ratio (male / female) overall was 0.7, indicating general trend skewed towards females, which also remained in the sex ratio (0.8) between the administrative areas of Manaus. Greater number of redemptions (55%) occurred in the city that has greater connectivity with continuous forest. It was also confirmed that the population of B. constrictor in the urban area of Manaus is mainly infested by Amblyomma dissimile and secondarily by Amblyomma aff. rotundatum. The prevalence and mean intensity (n° total of tick / n° total of snakes) high in all administrative areas, and over the months in Manaus, indicated that the infestation is apparently chronic throughout the city, throughout the year. The absence of a clear relationship between the surface area and the number of residents to the number of rescues of B. constrictor by administrative area of Manaus was not expected, and showed how the rescue effort public can be a unique opportunity to obtain robust information on the biology, ecology and conservation status of cryptic species like jiboia - Boa constrictor. / Atualmente quase 1/5 das espécies de répteis está ameaçada de extinção no mundo. Nesse cenário iminente de perda biológica, o crescimento acelerado da população humana e o adensamento urbano são considerados ameaças globais à diversidade reptiliana, mediante a destruição, modificação e homogeneização do ambiente natural, muito além dos limites da sede do município. Na paisagem urbana em expansão, as serpentes figuram entre os répteis primariamente impactados devido as suas peculiaridades ecológicas e comportamentais, as quais geralmente despertam temor em humanos ocidentais. Manaus, a cidade mais populosa do bioma Amazônia, desde a primeira década do século XXI vem acelerando a expansão da sua área urbana de forma desordenada sobre a floresta contínua circundante. Entre os vertebrados diretamente afetados por esse processo de degradação dos hábitats está a jiboia (Boa constrictor). Essa serpente, apesar de poder atingir até 4,2 m de comprimento total, consegue persistir em ambientes modificados, e tem sido um dos vertebrados com maior número de resgates pelo pode público em Manaus na última década. Entre 09/2010 e 11/2012, foram avaliados 222 exemplares de B. constrictor que foram resgatados na área urbana da capital amazonense. A frequência elevada de indivíduos de basicamente todos os tamanhos/idades, de ambos os sexos e distribuídos por toda a área urbana de Manaus indicou que a capital amazonense ainda comporta uma população robusta de B. constrictor. Não ocorreu relação entre a chuva acumulada nas últimas 24 horas e a ocorrência de resgates, indicando que as B. constrictor em Manaus não são simplesmente levadas pela chuva intensa, o que favoreceria a sua visualização pelos munícipes e o acionamento do resgate. Pelo contrário, a taxa de resgate pareceu refletir a movimentação sazonal da espécie-alvo, sendo que a precipitação mensal acumulada explicou 45% da variância do número de B. constrictor resgatadas nos respectivos meses. A razão sexual (macho/fêmea) geral foi de 0,7, indicando tendência enviesada para fêmeas, o que também se manteve na razão sexual (0,8) entre as zonas administrativas de Manaus. Número maior de resgates (55%) ocorreu na região da cidade que possui maior proximidade com a floresta contínua. Também foi evidenciado que a população de B. constrictor na área urbana de Manaus está infestada principalmente pelos carrapatos Amblyomma dissimile e secundariamente por Amblyomma aff. rotundatum. A prevalência e a intensidade média (n0 total de carrapatos/n0 total de serpentes) altas em todas as zonas administrativas, e ao longo dos meses em Manaus, indicaram que a infestação é aparentemente crônica por toda a cidade, ao longo de todo o ano. A ausência de relação evidente entre a área superficial e o número de habitantes com o número de resgates de B. constrictor por zona administrativa de Manaus não era esperado, e evidenciou o quanto o esforço de resgate público pode ser uma possibilidade única de obter informações robustas sobre a biologia, a ecologia e o estado de conservação de espécies crípticas como a jiboia - Boa constrictor.

Doctor of Philosophy / Department of Biology / Kimberly A. With / The loss, fragmentation, and degradation of grasslands have resulted in widespread declines in grassland birds. Nest predation is the leading cause of avian reproductive failure; therefore minimizing nest predation can lessen the severity of bird declines. Snakes are important predators of bird nests, but little is known about how snakes may enhance predation risk. To address this issue, I studied the habitat use, movement behavior, population genetic structure, and connectivity of snakes in the grasslands of northeastern Kansas. I addressed the connectivity of eastern yellowbelly racer (Coluber constrictor flaviventris) populations by using a landscape genetics approach at a broad scale (13,500 km2). I also radio-tracked the yellowbelly racer and Great Plains ratsnake (Pantherophis emoryi) at Konza Prairie Biological Station to understand their spatial ecology while simultaneously evaluating nest survival in grassland birds. Individual racers had limited dispersal (<3 km), but substantial admixture occurred within 30 km and populations were in migration-drift equilibrium and had high allelic diversity; therefore, racers must be abundant and continuously distributed for gene flow to be fluid throughout the region. Racers may be more likely to encounter bird nests, as they had more frequent movements and traversed greater distances on average than ratsnakes, which exhibited long periods of inactivity between directed movements. As for grassland birds, nest survival rates decreased with increasing shrubs and decreasing vegetation height. Discriminant function analysis revealed that successful nests were likely to occur in tall vegetation but reduced shrub cover, whereas higher shrub cover characterized snake habitats. Because snakes often use shrubs, nests in areas of increased shrubs may be at higher risk of predation by snakes. Targeted removal of shrubs may increase nest success by minimizing the activity of predators attracted to shrubs. Although predator removal is often a strategy for protecting bird populations, it may not be feasible in this instance, especially since snakes are a native component of the grassland community. Efforts to reduce snake predation on grassland bird nests should therefore focus on managing habitat within grasslands (i.e., shrubs) that influence snake activity, as no natural or anthropogenic habitat barriers currently limit snake movement across the landscape.

No description available.

Introdução: Apneia Obstrutiva do Sono (AOS) é prevalente em estados edematosos, especialmente em pacientes em hemodiálise (HD). Uma vez que o deslocamento noturno de fluidos (DNF) acarreta piora da AOS, nós elaboramos a hipótese de que a interferência na redistribuição de fluidos pelo uso de meias elásticas compressivas (MEC) atenuaria a gravidade da AOS, por mecanismos diferentes em comparação à terapia padrão para AOS, a pressão positiva em vias aéreas (CPAP). Métodos: este é um estudo randomizado e cross-over, que incluiu 14 pacientes dialíticos com AOS (índice de apneia/hipopneia - IAH > 5 eventos/hora) em exame de polissonografia (PSG), que era realizada em três momentos: basal, titulação de CPAP e após uma semana de uso diário de MEC. Circunferência cervical (CC), bioimpedância elétrica segmentar e variabilidade de frequência cardíaca (VFC) foram avaliadas antes e após cada exame de PSG. Resultados: A idade média foi 53±9 anos (57% de homens) e o índice de massa corporal foi 29,7±6,8 Kg/m². O IAH foi reduzido de 20,8 (14,2; 39,6) no exame basal para 7,9 (2,8; 25,4) durante titulação de CPAP e para 16,7 (3,5; 28,9) eventos/hora após uso de MEC (CPAP vs. basal, p=0,004; MEC vs. basal, p=0,017; e CPAP vs. MEC, p=0.017). Comparando basal, CPAP e MEC, o conteúdo de água noturna em membros inferiores foi menor com MEC (p=0,04), enquanto a água intracelular noturna em tronco foi maior (p=0,03). DNF basal, com CPAP e MEC foi de -183±72, -343±220, e -290±213ml, respectivamente (p=0,006). Houve aumento da circunferência cervical durante a noite durante o exame basal (0,7±0,4 cm), mas houve redução dessa circunferência após titulação com CPAP (-1,0±0,4 cm) e após uso de MEC (-0,4±0,8 cm) (CPAP vs. basal, p<0.0001; MEC vs. basal, p=0.001; CPAP vs. MEC, p=0.01). VFC, avaliada pelos componentes de alta e baixa frequência, demonstrou menor ativação simpática durante o exame de titulação de CPAP: OR: 11 (95% CI: 1,06 - 114,2), p=0,025, mas não com MEC: OR: 7,8 (95% CI: 0,75 - 82,2), p=0,059. Conclusões: tanto o CPAP quanto MEC melhoraram AOS em pacientes em HD, mas por mecanismos distintos: enquanto o CPAP reduziu o edema de vias aéreas superiores, ao exercer pressão local, o uso de MEC reduziu o DNF, ao evitar retenção de fluidos em membros inferiores, acumulando água no componente intracelular do tronco. Ativação simpática foi somente reduzida com uso de CPAP. / Background: Obstructive Sleep Apnea (OSA) is prevalent in edematous states, notably in hemodialysis (HD) patients. Once overnight fluid shift (OFS) augments OSA, we hypothesized that interfering in fluid redistribution by wearing compression stockings (CS) would attenuate OSA severity by different mechanisms in comparison to the standard treatment to OSA, the positive airway pressure (CPAP). Methods: This is a randomized crossover study that included 14 dialytic patients with OSA (apnea/hypopnea index - AHI >5 events/hour) by polysomnography (PSG), which was performed in three moments: at baseline, for CPAP titration, and one week after daily wearing of CS. Neck circumference (NC), segmental bioelectrical impedance and heart rate variability (HRV) were assessed before and after each PSG. Results: Mean age was 53±9 years (57% men) and body mass index was 29.7±6.8 kg/m2. AHI decreased from 20.8 (14.2; 39.6) at baseline to 7.9 (2.8; 25.4) during CPAP titration and to 16.7 (3.5; 28.9) events/hour after wearing CS (CPAP vs. baseline, p=0.004; CS vs. baseline, p=0.017; and CPAP vs. CS, p=0.017). Comparing baseline, CPAP and CS, nocturnal lower limbs water content was lower with CS (p=0.04), while nocturnal intracellular trunk water was higher (p=0.03). OFS at baseline, CPAP and CS was -183±72, -343±220, and -290±213ml, respectively (p=0.006). Overnight NC variation increased at baseline (0.7±0.4 cm), but decreased after CPAP titration (-1.0±0.4 cm) and while wearing CS (-0.4±0.8 cm) (CPAP vs. baseline, p<0.0001; CS vs. baseline, p=0.001; CPAP vs. CS, p=0.01). HRV, assessed by both high and low frequency components, showed a lower sympathetic activation during CPAP titration: OR: 11 (95% CI: 1.06 - 114.2), p=0.025, but not with CS: OR: 7,8 (95% CI: 0.75 - 82.2), p=0.059 Conclusions: Both CPAP and CS improved OSA in HD patients by different mechanisms: while CPAP reduced edema in upper airways by exerting local pressure, wearing CS reduced OFS by avoiding fluid retention in the legs, accumulating water in the intracellular component of the trunk. Sympathetic activation was decreased only with CPAP.

Introdução: A parede lateral da faringe tem importante papel no colapso da via aérea superior nos episódios de apneia obstrutiva do sono (AOS). Os dois principais músculos que formam esta região são o músculo palatofaríngeo (MPF) e o músculo constritor superior da faringe (MCSF). Estes músculos são classificados como esqueléticos e não possuem um padrão histológico de normalidade estabelecido. Os objetivos do estudo foram verificar a estrutura histológica das fibras do MPF e do MCSF em indivíduos controles sem síndrome da apneia obstrutiva do sono (SAOS), e avaliar se indivíduos portadores de SAOS apresentam alterações histológicas nestes músculos em comparação aos controles. Métodos: Foram avaliados 28 indivíduos adultos (faixa etária entre 18 e 55 anos de idade), sendo 17 portadores de SAOS grave e 11 controles. Destes 11 controles, 7 eram portadores de ronco primário, e 4 não apresentavam roncos e AOS. Coletaram-se fragmentos de MPF e de MCSF em cirurgia de faringoplastia lateral para os roncadores primários e apneicos graves, e em cirurgia de tonsilectomia das palatinas para os indivíduos com tonsilite crônica caseosa. Os espécimes musculares coletados foram congelados em nitrogênio líquido em até 3 horas após o procedimento cirúrgico. Por meio de colorações histológicas e imuno-histoquímicas, avaliou-se a histologia das fibras musculares no que tange a sua morfologia, a distribuição dos tipos de fibras, as dimensões do espaço intercelular, e a prevalência de fibras híbridas nos 2 músculos e em ambos os grupos. Resultados: O grupo-controle apresenta predomínio de fibras do tipo II, de contração rápida e alta fatigabilidade, nos MPF e MCSF, não havendo diferença estatística entre os dois músculos. Encontramos prevalência elevada de fibras híbridas no grupo-controle (45,45% no MPF e 27,27% no MCSF), sem diferença estatística entre os dois músculos. Quanto à comparação entre os grupos controle e SAOS, verificamos redução do percentual de fibras do tipo II do MCSF nos indivíduos com SAOS (p=0,04) quando comparados aos controles. Não houve diferença estatística na distribuição dos tipos de fibras musculares entre os 2 grupos no MPF. Conclusões: Os MPF e MCSF possuem composição histológica com predomínio de fibras do tipo II e prevalência elevada de fibras híbridas nos indivíduos sem SAOS. Os indivíduos portadores de SAOS possuem redução do percentual de fibras do tipo II no MCSF em comparação aos indivíduos sem SAOS, e isso pode ter implicações na redução da eficiência desta musculatura, podendo contribuir na etiopatogenia da AOS / Introduction: The lateral pharyngeal muscular wall plays an important role in upper airway collapse in obstructive sleep apnea (OSA) episodes. The two main muscles that form this anatomical site are the palatopharyngeal muscle (PPM) and the superior pharyngeal constrictor muscle (SPCM). These muscles are classified as skeletal and do not have an established normal histological pattern in literature. The objectives of the study were: verify the histological structure of PPM and SPCM fibers in control subjects without obstructive sleep apnea syndrome (OSAS), and evaluate whether OSAS individuals demonstrate histological changes in these muscles compared to controls. Methods: Twenty-eight adults (age range between 18 to 55 years old) were evaluated, 17 with severe OSAS and 11 controls. On the control group, 7 had primary snoring and 4 had no snoring or OSA. PPM and SPCM fragments were collected in lateral pharyngoplasty surgery for the primary snoring and severe OSAS patients and a palatine tonsillectomy was executed in individuals with chronic caseous tonsillitis. The collected muscles specimens were frozen in liquid nitrogen within 3 hours after the surgical procedure. Histological and immunohistochemical staining were used to evaluate the histology of muscle fibers concerning their morphology, the distribution of fiber types, the size of the intercellular space and the prevalence of hybrid fibers in the two muscles in both groups. Results: The control group showed predominance of type II fibers (fast contraction and high fatigability) in PPM and SPCM, without statistical difference between the two muscles. We found a high prevalence of hybrid fibers in the control group (45.45% in PPM and 27.27% in SPCM), without statistical difference between the two muscles. Regarding the comparison between the control and OSAS groups, we verified a reduction in the percentage of SPCM type II fibers in individuals with OSAS (p = 0.04) when compared to controls. There was no statistical difference in the percentage of muscle fiber types between the 2 groups in PPM. Conclusions: PPM and SPCM have histological composition with predominance of type II fibers and high prevalence of hybrid fibers in individuals without OSAS. Patients with OSAS have a reduction in the percentage of type II fibers in SPCM compared to controls, and this may have implications in the efficiency of this muscular function, which may contribute to the etiopathogenesis of OSAS