Background and Methods: Hypertension is a common problem in hemodialysis (HD). However, its behavior during the interdialytic period is not completely known and is infrequently monitored in clinical practice. Thus, for better understanding of interdialytic blood pressure (BP), we analyzed the interdialytic blood pressure profile using 44-hour ambulatory blood pressure monitoring (ABPM) data in 71 unselected, stable HD patients. Results: There was an increase in BP during the interdialytic period (awake day 1: 135/84 ± 23/14 mm Hg; awake day 2: 140/86 ± 22/15 mm Hg, p < 0.05; sleep day 1: 130/77 ± 24/15 mm Hg; sleep day 2: 136/80 ± 24/15 mm Hg, p < 0.05). The correlation between the average 44-hour BP and interdialytic weight gain (IDWG) was not significant (r = –0.07 for systolic BP and r = –0.09 for diastolic BP). The number of non-dipper patients was high, 77% on interdialytic day 1 and 83% on interdialytic day 2 for systolic BP. Uncontrolled hypertension (average 44 h BP ≧135/85 mm Hg) was diagnosed in 58 (55%) patients. Patients with uncontrolled hypertension had higher pre- and posthemodialysis BP, higher BP on each interdialytic day and night, and higher night/day diastolic BP ratio on the second interdialytic day. These patients were also taking a greater number of vasoactive medications (1.5 vs. 0.6 in those with controlled BP, p = 0.001). There were no significant differences related to kt/V, hematocrit, or weekly erythropoietin dose between patients with controlled or uncontrolled BP. Hemodialysis shift assignment (morning or afternoon) did not impact on BP levels or diurnal profile. Conclusion: In HD patients, interdialytic BP is often poorly controlled, there is a progressive rise in BP, and a trend toward loss of nocturnal decline in BP as the interdialytic period progresses. Further research is needed to determine whether treatment directed to interdialytic BP changes can alter outcomes in HD patients.

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RESUMO:Considerando o cavalo Crioulo um cavalo de sela, as medidas angulares dos eixos ósseos das principais articulações envolvidas na dinâmica do movimento devem ser avaliadas para melhor caracterização do padrão racial. Objetivou-se com o presente estudo estabelecer uma relação dos ângulos das articulações escápulo-umeral, coxo-femural e tíbio-metatarsiana, com o desempenho desses animais na prova de andamento, relacionando assim diretamente ângulos e notas. Foram avaliados 74 equinos que participaram das Classificatórias do Freio de Ouro, as medidas aferidas foram: ângulo da escápula com o solo, ângulo do íleo com o solo e ângulo tíbiometatársico. A articulação que manteve correlação positiva de influência em todas as etapas da prova foi à articulação escápulo-umeral. Os animais que obtiveram as melhores notas em média foram os que apresentaram ângulo menor que 53° para a articulação escápulo-umeral. Já as articulações coxo-femural e tíbio-metatársica demonstraram uma grande variação de resultado durante a prova. ABSTRACT:Considering the Crioulo a saddle horse, the angular measures of the bone axles of the principal articulations wrapped in the dynamic one of the movement must be valued for better characterization of the racial standard. The objective by the present study to establish a relation of the angles of the articulations scapular-humeral, lame-femoral and tibio-metartarsal, with the performance of these animals in the proof of gait, making a list so straightly of angles and notes. There were valued 74 equine ones that participated of the Qualifying ones of the Golden brake, the checked measures were: angle of the hook with the ground, angle of the ileum with the ground and tibio-metatarsal angle. The relationship that has kept a positive correlation of influence in all stages of the race was the scapular-humeral joint. Animals that received the best grades in those who had averaged less than 53 ° angle to the scapular-humer al joint. The articulation that maintained positive correlation of influence in all stages of the proof is the articulations scapular-humeral. Already the articulations lame-femoral and tibio-metartasal demonstrated a great variation of result during the competition.

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Background: Cardiac anomalies account for 3.5% of congenital defects in horses. Tetralogy of Fallot (TOF) is characterized by ventricular septal defect, pulmonary stenosis, dextroposition the aorta and right ventricular hypertrophy secondary.Pentalogy of Fallot (POF) is a variation and is characterized by a defect in the right atrioventricular valve or persistence of the ductus arteriosus, in addition to the other defects observed in tetralogy. Affected animals usually have stunted growth,exercise intolerance, weakness, lethargy, cyanosis, dyspnea and syncope. The aim of this study was to describe a case of POF, as diagnosed in a Crioulo foal in southern Brazil.Case: Clinical signs were observed at the ffth day of life and were characterized by cyanosis, intense tracheal stertor, tachycardia, marked heart murmur, HR 160 bpm, RR 80 breaths/min, T 39.8°C and syncope. These signs worsened with physical activity. Endoscopic evaluation of the upper airways revealed no anatomical conformation changes or tissue dysfunction. A cardiac ultrasound showed a loss of continuity of the interventricular septum, right ventricular wall thickening, and a hyperechoic appearance of the area where the right atrioventricular valve (tricuspid) should be. The crises have become more severe and more frequent, the animal began to show signs of ischemia, such as loss of motor coordination and limited mobility. The foal died at 15 days old. At necropsy the liver was congested and had a nutmeg appearance, there was foam in the trachea, and the lungs were edematous. There was hydropericardium, and the heart was increased in size with a globoid shape. The heart had thickening of the walls of the right and left ventricle and pulmonary artery stenosis. There was also an oval orifce 2.5 cm in diameter in the interventricular septum connecting the ventricles (ventricular septal defect), an overriding aorta and aplasia of the tricuspid valve. Histologically the liver had centrilobular to mediozonal necrosis, and there was pulmonary edema and congestion.Discussion: The diagnosis of pentalogy of Fallot was based on the clinical signs, the ultrasound results and the macroscopic lesions observed at necropsy. Tetralogy of Fallot is one of the most common congenital cardiac malformations observed in horses, however, in a study of congenital malformations in this species, only 3.5% had cardiac malformations out ofthe 608 foals examined. The prevalence of heart defects in horses compared with other domestic species is relatively low (0.1% - 0.5%). In this case, the malformation was probably sporadic because the foal was the only animal to be born with this malformation on the farm. In the Crioulo breed, congenital defect reports are scarce. In a retrospective study of equine diseases in southern Brazil over a period of 35 years, malformations were not observed in 708 horses of this breed, whichis the predominant breed in the region. In the present case, the fact that the mare had another three healthy foals with the same stallion reduces the possibility that this was a case of hereditary origin. It is likely that this case is of a sporadic nature with no chance of determining the cause. The differential diagnoses in animals with lethargy, cyanosis, and exerciseintolerance or syncope include complicated or multiple cardiac defects. There are no previous reports of TOF and POF in the Crioulo breed in Brazil.Keywords: Pentalogia de Fallot, cardiac ultrasound, cardiac malformation, horse.