1,626 results on '"Isquémia"'
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102. Burden of ischemic heart disease in Spain: incidence, hospital mortality and costs of hospital care
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Josep Darbà and Alicia Marsà
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Male ,Cost de l'assistència sanitària ,Malalties cardiovasculars ,Incidence ,Health Policy ,Myocardial Infarction ,Myocardial Ischemia ,General Medicine ,Política sanitària ,Hospitals ,Cardiovascular diseases ,Ischemia ,Spain ,Mortalitat ,Isquèmia ,Humans ,Medical policy ,Female ,Pharmacology (medical) ,Hospital Mortality ,Mortality ,Hospital Costs ,Cost of medical care ,Retrospective Studies - Abstract
Ischemic heart disease (IHD) is the leading global cause of death and is assumed to entail a significant social and economic burden globally. This study aimed to evaluate incidence and mortality trends of IHD in Spain and to estimate direct medical costs.Admission files corresponding to patients with IHD registered between 2011 and 2019 were obtained from a Spanish hospital discharge database and analyzed in a retrospective study.Admission data corresponding to 814,740 patients with IHD was analyzed. The majority of patients were males, and about half of the hospitalizations were due to an acute myocardial infarction. Incidence decreased significantly in most age groups over time, while hospital mortality rate remained stable (4.4%). Additionally, mortality rate was significantly higher among females (6.6%). Median admission cost was €5175; the higher costs per admission were found in patients with an acute myocardial infarction and in admissions with an ICU stay. The annual cost of hospital care was €693.8 million.Despite the decreasing trends described in the general population, hospital mortality rate was constant among hospitalized patients during the study period. The higher hospital mortality rate described among females should be considered in further studies and protocol revisions.
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- 2022
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103. IDENTIFICACIÓN DE LAS ISOFORMAS SUR1 Y LA REGULACIÓN DE SU EXPRESIÓN POR METILACIÓN DESPUÉS DE UN PERIODO ISQUÉMICO EN TEJIDOS DE LA RATA.
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Iván, Alquisiras-Burgos, Edith Alejandra, Cabello-Ramírez, Irlanda, Peralta-Arrieta, Iván, Antonino-Olguín, Mónica, Espinoza-Rojo, Martha Eugenia, Ruiz-Tachiquín, Hilda Alicia, Valdez-Salazar, Alma, Ortiz-Plata, Alicia, Sánchez-Mendoza, María, Sánchez-Aguilar, Arturo, Hernández-Cruz, and Penélope, Aguilera
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METHYLATION , *CARRIER proteins , *ISCHEMIA , *PROMOTERS (Genetics) , *CONFERENCES & conventions - Abstract
Objetivo: Identificar los niveles de expresión de las isoformas del receptor de sulfonilurea 1 (SUR1) en tejidos de la rata y evaluar el estado de metilación de su promotor subsecuente a un episodio de isquemia. Antecedentes: El SUR1 es un regulador de canales iónicos monovalentes asociado a la formación del edema en la isquemia cerebral; este evento induce la sobreexpresión de la isoforma de SUR1 de 65 kDa, la cual se expresa abundantemente en el corazón en condiciones fisiológicas. Debido a que en mamíferos, la metilación del DNA es un mecanismo epigenético implicado en la expresión diferencial de isoformas, hipotetizamos que podría estar involucrada en la regulación de la expresión de esta isoforma. Métodos. Se indujo isquemia cerebral mediante la oclusión de la arteria cerebral media (2 h/24 h de reperfusión). La isquemia al miocardio se realizó ocluyendo la arteria coronaria izquierda (30 min/24 h reperfusión). Las isoformas de SUR1 se identificaron por SDS-PAGE seguido de Western blot con Ab a-SUR1 en muestras proteicas de corteza cerebral y de ambos ventrículos y aurículas cardíacas. Los exones del mRNA de SUR1 expresados en los diferentes tejidos de la rata se identificaron por PCR de punto final. El estado de metilación de la región distal del promotor del gen Abcc8 (que codifica para SUR1) se analizó en DNA extraído de los tejidos, previamente restringido con enzimas sensibles a la metilación (Acil y BstUI). No. 92/20 (CF-2019/170733). Resultados: Se identificaron dos isoformas de SUR1 con un peso aproximado de 170 y 65 kDa en todos los tejidos analizados a excepción de testículo y cerebro; este resultado coincide con la amplificación de todos los exones del mRNA en los tejidos analizados. La isquemia cerebral produjo un incremento en la expresión de ambas isoformas en el cerebro mientras que la isquemia miocárdica inhibió su expresión en corazón. La ausencia de amplificación de los fragmentos de la zona distal del promotor Abcc8, previamente restringido con Acil y BSTUI, indicó que no hay metilación de DNA en esa región. Conclusión: Ambas isoformas de SUR1 (170 y 65 kDa) se expresan en diferentes tejidos de la rata. La expresión diferencial de las isoformas de SUR1 en condiciones fisiológicas e isquémicas no está asociado a la metilación de la región promotora localizada de -591 a -231 bases del sitio de inicio de la transcripción. Esto sugiere que la metilación en otros sitios, otra región u otro mecanismo están implicados en la regulación. [ABSTRACT FROM AUTHOR]
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- 2024
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104. Isquemia miocárdica: conceptos básicos, diagnóstico e implicaciones clínicas. Tercera parte
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Pedro R. Moreno and Juan H. del Portillo
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Enfermedad coronaria ,Isquemia ,Cardiopatía isquémica ,Hibernación ,Flujo sanguíneo ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
El término «cardiopatía isquémica» se refiere a la disfunción del ventrículo izquierdo secundaria a infarto del miocardio, miocardio isquémico viable o enfermedad coronaria severa documentada por arteriografía coronaria, la cual tiene un pobre pronóstico, con una supervivencia del 45% a 5 años. El tratamiento de la cardiopatía isquémica involucra la estimación de la viabilidad en el miocardio afectado para determinar si la revascularización puede generar una remodelación positiva que mejore la función del ventrículo izquierdo. Existen cuatro modalidades básicas usadas en la práctica clínica para calcular la viabilidad miocárdica: tomografía de emisión simple de positrones, tomografía por emisión de positrones, ecocardiograma estrés y resonancia magnética cardiaca. Hoy en día hay estudios que demuestran que la terapia médica mejora la función del ventrículo izquierdo en la cardiopatía isquémica, independiente de la presencia o no de viabilidad o de la revascularización miocárdica; por tanto es posible que otros factores como la cantidad de remodelado, los volúmenes del ventrículo izquierdo, la insuficiencia mitral y la fracción de eyección puedan afectar también los desenlaces. Se requiere definir de manera clara los estadios del remodelado ventricular izquierdo en los cuales la presencia de viabilidad es benéfica y las etapas en las que el remodelado es reversible con la revascularización miocárdica. En cuanto a los métodos para determinar la viabilidad, la resonancia magnética parece dar más respuestas al respecto, ya que puede aportar información adicional relacionada con dimensiones del ventrículo izquierdo, fracción de eyección, fibrosis miocárdica y anormalidades valvulares.
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- 2017
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105. Efecto terapéutico del alprostadil en pacientes con isquemia crítica terminal de los miembros inferiores
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Alfredo J. Karles-Ernotte, Aníbal Bermúdez-Posada, Héctor M. Rincón-Sánchez, Andrea T. Padilla-Castro, Katherine Drews-Elger, Mauricio Novoa-Leal, and Heinz G. Hiller-Correa
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Enfermedad arterial periférica ,Isquemia ,Prostaglandinas ,Reperfusión ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objetivo: El manejo de la isquemia crítica de los miembros inferiores representa un reto para el cirujano vascular debido a la alta tasa de amputaciones y mortalidad. Las opciones de manejo actuales: puente femorodistal, angioplastia con o sin la colocación de Stents y la resección de la placa con láser o de manera mecánica, presentan a largo plazo una tasa de éxito muy baja y un número de amputaciones supracondíleas que continúa siendo elevado. Métodos: Para este estudio prospectivo se reclutaron 173 pacientes con diagnóstico de estadio avanzado, con isquemia crítica de miembro inferior quienes fueron tratados con alprostadil (60 – 120 mcgr/día) por vía intravenosa sistémica por 28 días. La respuesta se midió clínicamente por mejoría del llenado capilar y con el uso de la escala análoga visual del dolor. Resultados: Al momento del alta hospitalaria el 94.3% de los pacientes mejoró el puntaje en la escala análoga visual del dolor (p < 0.0001). El seguimiento a más de un año del tratamiento con alprostadil mostró que el 97% de los pacientes mejoró significativamente su estadio de isquemia, evitándose así una amputación mayor. No se observó respuesta al tratamiento en pacientes previamente intervenidos por vía endovascular (5 pacientes). Conclusiones: El tratamiento de pacientes con isquemia crítica de miembro inferior con alpostadil por infusión intravenosa, con bolos diarios de entre 60 y 120 mcg durante 28 días, este medicamento es seguro y presenta mínimos efectos secundarios. Esta terapia mejora sustancialmente el estadio funcional de Rutherford en estos pacientes y evita amputaciones mayores.
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- 2017
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106. Isquemia miocárdica: conceptos básicos, diagnóstico e implicaciones clínicas. Segunda parte
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Pedro R. Moreno and Juan H. del Portillo
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Enfermedad coronaria ,Isquemia ,Cardiopatía isquémica ,Hibernación ,Flujo sanguíneo ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
La isquemia miocárdica puede ser irreversible o reversible dependiendo de diferentes factores moleculares y fisiológicos. En la isquemia miocárdica irreversible se presentan tres tipos de muerte celular a nivel miocárdico: la necrosis, la apoptosis y la autofagia; mientras en la isquemia reversible la restauración de la función de los miocitos está determinada por factores como el restablecimiento temprano del flujo sanguíneo coronario y fenómenos de pre y posacondicionamiento isquémico. Conceptos como el miocardio aturdido (disfunción mecánica temporal luego de una lesión isquémica pero con flujo sanguíneo normal en ausencia de cualquier lesión irreversible) y el miocardio hibernante (región miocárdica viable, sin contractilidad) son formas quiescentes de la función cardiaca y explican un poco la capacidad del miocardio de restablecer su funcionamiento normal luego de un episodio de isquemia.
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- 2016
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107. Isquemia miocárdica: conceptos básicos, diagnóstico e implicaciones clínicas. Primera parte
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Pedro R. Moreno and Juan H. del Portillo
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Enfermedad coronaria ,Isquemia ,Cardiopatía isquémica ,Hibernación ,Flujo sanguíneo ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
La isquemia miocárdica es el conjunto de una serie de fenómenos fisiológicos que se manifiesta por condiciones clínicas como isquemia silente, angina estable y síndromes coronarios agudos. Diversos mecanismos de la regulación del flujo sanguíneo, la demanda miocárdica, la liberación de adenosina y la función del endotelio en las arterias coronarias son claves para mantener la irrigación miocárdica y han sido la base fisiológica para el desarrollo de pruebas de detección de isquemia como lo es el flujo de reserva fraccional, que hoy día hace parte de las recomendaciones de las guías.
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- 2016
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108. Serial High-Sensitivity Troponin T in Post-Primary Angioplasty Exercise Test
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Humberto Andres Vaz, Ana Paula Vanz, and Iran Castro
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Troponina T ,Isquemia ,Infarto do Miocárdio ,Teste de Esforço ,Angioplastia ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background: The kinetics of high-sensitivity troponin T (hscTnT) release should be studied in different situations, including functional tests with transient ischemic abnormalities. Objective: To evaluate the release of hscTnT by serial measurements after exercise testing (ET), and to correlate hscTnT elevations with abnormalities suggestive of ischemia. Methods: Patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty were referred for ET 3 months after infarction. Blood samples were collected to measure basal hscTnT immediately before (TnT0h), 2 (TnT2h), 5 (TnT5h), and 8 hours (TnT8h) after ET. The outcomes were peak hscTnT, TnT5h/TnT0h ratio, and the area under the blood concentration-time curve (AUC) for hscTnT levels. Log-transformation was performed on hscTnT values, and comparisons were assessed with the geometric mean ratio, along with their 95% confidence intervals. Statistical significance was assessed by analysis of covariance with no adjustment, and then, adjusted for TnT0h, age and sex, followed by additional variables (metabolic equivalents, maximum heart rate achieved, anterior wall STEMI, and creatinine clearance). Results: This study included 95 patients. The highest geometric means were observed at 5 hours (TnT5h). After adjustments, peak hscTnT, TnT5h/TnT0h and AUC were 59% (p = 0.002), 59% (p = 0.003) and 45% (p = 0.003) higher, respectively, in patients with an abnormal ET as compared to those with normal tests. Conclusion: Higher elevations of hscTnT may occur after an abnormal ET as compared to a normal ET in patients with STEMI.
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- 2016
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109. Evaluación de los criterios apropiados para la indicación de ecocardiografía de estrés en un centro cardiovascular de referencia
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Juan K. Urrea, Luis M. Benítez, Hubert Ruiz, Álvaro Barrera, Cristian A. Urrea, and Ángel A. García
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Ecocardiografía ,Diagnóstico ,Isquemia ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Reseña: El propósito de este estudio es evaluar la aplicación clínica e indicación de los criterios apropiados para la ecocardiografía de estrés de acuerdo a la Fundación del Colegio Americano de Cardiología/Sociedad Americana de Ecocardiografía, en la práctica diaria de un centro cardiovascular de referencia. Materiales y métodos: Fueron incluidos los estudios consecutivos realizados entre enero de 2012 y julio de 2013. Los datos fueron revisados, analizados y clasificados por cuatro cardiólogos expertos teniendo en cuenta: la demografía, la especialidad que refiere, la indicación primaria y su clasificación final como apropiados, inapropiados o inciertos. Resultados: Un total de 1.556 estudios fueron incluidos inicialmente, 450 fueron excluidos por estar relacionados con programas de trasplante de órgano sólido y en 170 no se pudo determinar una indicación clara para el estudio. Los 936 estudios restantes (85%) fueron analizados para la determinación de criterios apropiados. De estos 679 (73%) tenían una indicación apropiada, 70 (7%) eran inciertos y 187 (20%) fueron inapropiados. Cuatrocientos veintiocho (46%) fueron referidos por medicina interna, 375 (40%) por cardiología, 51 (5%) por anestesiología y 82 (10%) por medicina general y otras especialidades. Un total de 159 (17%) estudios arrojaron un resultado anormal, todos ellos estaban apropiadamente indicados, ninguno fue anormal en los inapropiadamente indicados. Conclusiones: La revisión de la aplicación de los criterios apropiados para la ecocardiografía de estrés no solo permite una implementación clínica efectiva en un centro cardiovascular de referencia, sino que también estratifica razonablemente la posibilidad de tener un resultado anormal en aquellos con una indicación apropiada. Sin embargo, esto debería validarse extensamente en una cohorte multicéntrica.
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- 2016
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110. A importância do uso precoce de hialuronidase no tratamento de oclusão arterial por preenchimento de ácido hialurônico
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Ritha de Cássia Capelato Rocha, Luana Bertelli Castilho, Danielle Mechereffe do Amaral Blaas, Reinaldo Tavares Júnior, Ana Paula Tavares, and Mariana Isis Wanczinski
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Dermatologia ,Isquemia ,Reperfusão ,Dermatology ,RL1-803 - Abstract
A isquemia cutânea é um dos eventos adversos vasculares decorrentes da aplicação de ácido hialurônico, causada por embolia arterial. A aplicação precoce de hialuronidase representará o sucesso da degradação e reversão do quadro que pode ser grave e causar danos ao paciente. Relatam-se casos com suspeita de oclusão arterial no qual foi realizada degradação com hialuronidase em diferentes períodos. Tal análise permitiu observar que o tempo de degradação e a eficácia do procedimento relacionam-se com tempo de intervenção
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- 2018
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111. Tortuosidade da artéria basilar como fator preditivo da eficácia da terapia adjuvante com heparina na perda auditiva neurossensorial súbita idiopática unilateral
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Woongsang Sunwoo
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medicine.medical_specialty ,medicine.drug_class ,Hearing Loss, Sensorineural ,Heparina ,Ischemia ,03 medical and health sciences ,Magnetic resonance imaging ,Artéria basilar ,0302 clinical medicine ,Internal medicine ,medicine.artery ,otorhinolaryngologic diseases ,medicine ,Adjuvant therapy ,Basilar artery ,Humans ,Hearing loss, unilateral ,030223 otorhinolaryngology ,Glucocorticoids ,Retrospective Studies ,medicine.diagnostic_test ,Heparin ,business.industry ,Anticoagulant ,Anticoagulants ,Retrospective cohort study ,Hearing Loss, Sudden ,medicine.disease ,Isquemia ,Treatment Outcome ,Otorhinolaryngology ,Basilar Artery ,Cardiology ,Etiology ,Audiometry, Pure-Tone ,Steroids ,business ,030217 neurology & neurosurgery ,Perda auditiva unilateral ,Imagem de ressonância magnética ,medicine.drug - Abstract
Introduction Cochlear ischemia is hypothesized as one of the major etiologies of idiopathic sudden sensorineural hearing loss. Therefore, anticoagulant therapies are designed to be beneficial in certain patients with this condition. Objective This study aimed to determine which patients with idiopathic sudden sensorineural hearing loss would benefit from heparin treatment as adjuvant therapy. Methods In total, 134 patients who underwent magnetic resonance imaging for unilateral idiopathic sudden sensorineural hearing loss at a tertiary referral hospital between January 2014 and December 2018 were included in this retrospective study. All patients received Intratympanic steroid injections or heparin therapy plus oral corticosteroids. Radiological parameters of the vertebrobasilar system and clinical data from pre- and post-treatment assessments were analyzed. Results Most patients (71.6%) had a tortuous basilar artery The 65 patients with severe-to-profound idiopathic sudden sensorineural hearing loss showed a significant relationship between idiopathic sudden sensorineural hearing loss laterality and basilar artery displacement to the opposite side (p= 0.036), while the 69 patients with mild-to-moderate idiopathic sudden sensorineural hearing loss did not (p= 0.950). Additionally, the degree of basilar artery tortuosity was significantly associated with the degree of hearing impairment in the severe-to-profound idiopathic sudden sensorineural hearing loss group (p= 0.015). When idiopathic sudden sensorineural hearing loss occurred on the opposite side to basilar artery displacement, the improvement of hearing was significantly greater in patients treated with heparin than in those treated with intratympanic steroids (p= 0.041). Conclusion In a subset of patients with severe-to-profound idiopathic sudden sensorineural hearing loss, basilar artery tortuosity had a significant directional relationship with idiopathic sudden sensorineural hearing loss laterality. In these selected patients, a significant effect of heparin therapy on improving hearing was observed. Resumo Introdução A isquemia coclear é considerada uma das principais etiologias da perda auditiva neurossensorial súbita idiopática. Portanto, espera-se que as terapias anticoagulantes sejam benéficas em certos pacientes com esse diagnóstico. Objetivo Determinar quais pacientes com perda auditiva neurossensorial súbita idiopática se beneficiariam do tratamento com heparina como terapia adjuvante. Método Foram incluídos neste estudo retrospectivo 134 pacientes submetidos à ressonância magnética por perda auditiva neurossensorial súbita idiopática unilateral em um hospital de referência terciário entre janeiro de 2014 e dezembro de 2018. Todos os pacientes receberam injeções intratimpânicas de corticosteroides ou terapia com heparina juntamente com corticosteroides orais. Os parâmetros radiológicos do sistema vertebro-basilar e os dados clínicos das avaliações pré e pós-tratamento foram analisados. Resultados A maioria dos pacientes (71,6%) apresentava uma artéria basilar tortuosa. Os 65 pacientes com perda auditiva neurossensorial súbita idiopática grave a profunda mostraram uma relação significativa entre a lateralidade da perda auditiva e o deslocamento da artéria basilar para o lado oposto (p = 0,036), enquanto os 69 pacientes com perda auditiva neurossensorial súbita idiopática leve a moderada não apresentaram esse deslocamento (p = 0,950). Além disso, o grau de tortuosidade da artéria basilar foi significativamente associado ao grau de deficiência auditiva no grupo com perda auditiva neurossensorial súbita idiopática grave a profunda (p = 0,015). Quando a perda auditiva neurossensorial súbita idiopática ocorreu no lado oposto ao deslocamento da artéria basilar, a melhoria da audição foi significativamente maior nos pacientes tratados com heparina do que naqueles tratados com injeções intratimpânicas de corticosteroide (p = 0,041). Conclusão Em um subgrupo de pacientes com perda auditiva neurossensorial súbita idiopática grave a profunda, a tortuosidade da artéria basilar mostrou uma relação direcional significativa com a lateralidade da perda auditiva. Nesses pacientes selecionados, foi observado um efeito significante da terapia com heparina na melhoria da audição.
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- 2022
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112. Mecanismos moleculares en el daño por isquemia en la preservación fría del hígado graso
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Gómez Bardallo, Raquel, Carbonell i Camós, Teresa, Paniselló Roselló, Arnau, and Universitat de Barcelona. Facultat de Biologia
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Inflammation ,Reperfusió (Fisiologia) ,Estrès oxidatiu ,Ischemia ,Oxidative stress ,Malalties del fetge ,Preservation of organs ,Conservació d'òrgans ,Isquèmia ,Inflamació ,Liver diseases ,Reperfusion (Physiology) - Abstract
[spa] La lesión por isquemia-reperfusión (IR) es la mayor causa de pérdida y disfunción de tejidos y órganos en trasplantes clínicos, como es el trasplante hepático. Durante la isquemia, la carencia de oxígeno provoca acumulación de especies reactivas de oxígeno (ROS), que causan daños a los hepatocitos a través de la peroxidación lipídica, la oxidación de proteínas, la disfunción mitocondrial y el daño al ADN. Posteriormente, las células de Kupffer y los neutrófilos acumulados se activan en respuesta a la muerte de los hepatocitos y causan inflamación hepática. Además, la acumulación de succinato y la depleción de trifosfato de adenosina (ATP) se han considerado eventos claves para prever los daños moleculares producidos en la reperfusión. El incremento de la demanda de hígados para el trasplante así como los hábitos actuales de la población hacen que se considere la utilización de hígados esteaóticos, menos óptimos y con mayores riesgos post-trasplantes, de cara a aumentar el pool y reducir las listas de espera. La preservación de los injertos hepáticos ha resultado ser una de las terapias más efectivas para conservar el tejido y minimizar el daño por IR, como es la preservación estática en frío y la utilización de los medios de preservación. Las soluciones de preservación clásicas, como son la solución University of Wisconsin (UW) y la solución HTK (histidina-triptófano-cetoglutarato), han sido las más utilizadas hasta la actualidad. Sin embargo, en los últimos años se han desarrollado nuevas estrategias de preservación, como es la solución Institute George Lopez (IGL-1), que contiene Polietilenglicol 35 (PEG35) como agente oncótico y glutatión (GSH) como antioxidante. El objetivo de esta tesis será evaluar la eficacia de los medios de preservación disponibles actualmente así como el papel del PEG35 y el GSH en la preservación estática en frío de hígados grasos. Para ello, se preservaron los injertos hepáticos grasos (24 h, 4 ºC) en las soluciones de preservación IGL-1 y sus modificaciones (IGL-0, sin PEG35; IGL- 2, PEG35 y GSH aumentado) y las soluciones clásicas UW y HTK. Los resultados obtenidos demuestran que el PEG35 mejora el estado hepático y confiere protección mitocondrial durante la isquemia, a través de la activación de la enzima mitocondrial Aldehído Deshidrogenasa 2 (ALDH2), reduciendo la acumulación de succinato y manteniendo los niveles de ATP respecto a la preservación sin PEG35. Además, activa el factor de transcripción Nrf2, promoviendo la respuesta redox y reduciendo el estrés oxidativo (TBARS, 4-HNE y AOPP). Por otro lado, en los hígados la preservados en las soluciones con presencia de GSH y PEG35 se presentan niveles menores de estrés oxidativo, inflamación, apoptosis y piroptosis; así como IGL-2 previene la secreción de citoquinas inflamatorias respecto las soluciones UW y HTK. Finalmente, dado que la solución IGL-2 muestra una mejora de la calidad del injerto, se propone su utilización en la preservación dinámica hipotérmica oxigenada (HOPE). En conclusión, la adición de PEG35 y GSH a los medios de preservación ha demostrado ser protectora en la preservación estática en frío de los hígados esteatósicos., [eng] Ischemia-reperfusion (I/R) injury is the main cause of loss and dysfunction of tissues and organs in clinical transplants, such as liver transplants. During ischemia, oxygen deprivation causes accumulation of reactive oxygen species (ROS), which cause damage to hepatocytes through lipid peroxidation, protein oxidation, mitochondrial dysfunction, and DNA damage. Subsequently, the accumulated Kupffer cells and neutrophils become activated in response to hepatocyte death and cause hepatic inflammation. In addition, the accumulation of succinate and the depletion of adenosine triphosphate (ATP) have been considered key events to prevent the molecular damage produced in reperfusion. The increased demand for livers for transplantation, as well as the current habits of the population, make the use of steaotic livers, less optimal and with higher post-transplant risks, be considered in order to increase the pool and reduce waiting lists. . Ischemic preconditioning has proven to be one of the most effective therapies for preserving tissue and minimizing I/R damage, such as cold static dehydration and the use of dehydration media. Classical solutions, such as the University of Wisconsin (UW) solution and the HTK (histidine-tryptophan-ketoglutarate) solution, have been the most widely used to date. However, in recent years new development strategies have been developed, such as the Institute George Lopez (IGL-1) solution, which contains Polyethylene Glycol 35 (PEG35) as an oncotic agent and glutathione as an antioxidant. The objective of this thesis will be to evaluate the efficacy of currently available methods of stabilization as well as the role of PEG35 and glutathione in cold static stabilization of fatty livers. For this, the fatty liver grafts were preserved (24 h, 4 ºC) in the solutions of IGL-1 and its modifications (IGL-0, without PEG35; IGL-2, PEG35 and warm glutathione) and the classic UW and HTK solutions. The results obtained show that PEG35 improves liver status and protects mitochondrial protection during ischemia, through the activation of the mitochondrial enzyme Aldehyde Dehydrogenase 2 (ALDH2), reduces the accumulation of succinate and maintains ATP levels with respect to achieved sin PEG35. Furthermore, it activates the transcription factor Nrf2, promotes the redox response and reduces oxidative stress (TBARS, 4-HNE and AOPP). On the other hand, livers preserved in UW and HTK solutions show higher levels of oxidative stress, inflammation, apoptosis and pyroptosis; while IGL-2 prevents oxidation and inflammation. Finally, given that the IGL-2 solution shows an improvement in graft quality, its use in hypothermic oxygenated dynamics (HOPE) is proposed. In conclusion, enhancement of PEG35 and glutathione to media proved to be protective in cold static due to steatotic livers.
- Published
- 2023
113. Protección miocárdica por condicionamiento isquémico a distancia en la revascularización coronaria
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Rudy Hernández Ortega, María Oslaida Agüero Martínez, Osvaldo González Alfonso, María Idoris Cordero Escobar, and Teddy Osmín Tamargo Barbeito
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condicionamiento isquémico a distancia ,isquemia ,reperfusión ,revascularización coronaria ,parámetros enzimáticos ,Anesthesiology ,RD78.3-87.3 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Introducción: Una serie de breves períodos de isquemias a distancia, previo al evento isquémico mayor, pueden limitar el daño miocárdico producido por la isquemia/reperfusión. Objetivo: Evaluar la utilidad del condicionamiento isquémico a distancia, en pacientes programados para procedimientos quirúrgicos de revascularización coronaria. Métodos: Se realizó un estudio cuasiexperimental, explicativo, comparativo con control histórico, en dos grupos de 247 pacientes, propuestos para revascularización coronaria. Se colocó un torniquete en el brazo derecho, en el grupo estudio, alternando 3 insuflaciones con 3 desinsuflaciones con una presión de 200 mmHg, manteniéndola 5 min cada una. Este proceder se realizó previo, durante y después del evento isquémico mayor, provocado por el pinzamiento de la arteria coronaria. Resultados: Se logró una disminución significativa de los parámetros enzimáticos. No se encontraron diferencias significativas (p> 0,05) según un conjunto de variables que representan el estado inicial de los pacientes.
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- 2019
114. Myocardial protection by ischemic remote conditioning in coronary revascularization
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Rudy Hernández Ortega, Maria Oslaida Agüero Martínez, Osvaldo González Alfonso, María Idoris Cordero Escobar, and Teddy Osmín Tamargo Barbeito
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condicionamiento isquémico a distancia ,isquemia ,reperfusión ,revascularización coronaria ,parámetros enzimáticos ,protección cardiaca ,Anesthesiology ,RD78.3-87.3 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Introduction: A series of short periods of distant ischemia, prior to the major ischemic event, can limit the myocardial damage produced by ischemia or reperfusion. Objective: To evaluate the usefulness of remote ischemic conditioning in patients scheduled for surgical procedures of coronary revascularization. Methods: A quasi-experimental, explanatory, comparative study with historical control was conducted in two groups of 247 patients proposed for coronary revascularization. A tourniquet was placed in the right arm in the study group, alternating 3 insufflations with 3 dessufflations with a pressure of 200 mmHg, keeping each for 5 minutes. This procedure was performed before, during and after the major ischemic event, caused by the impingement of the coronary artery. Results: A significant decrease in enzymatic parameters was achieved. No significant differences were found (p> 0.05) according to a set of variables that represent the initial state of the patients.
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- 2019
115. Whole-Body Vibration Training Increases Myocardial Salvage Against Acute Ischemia in Adult Male Rats
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Shahnaz Shekarforoush and Mohammad Reza Naghii
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Ratos Wistar ,Composição Corporal ,Vibração ,Osteoporose/prevenção e controle ,Viscosidade Sanguínea ,Isquemia ,Doenças Cardiovasculares ,Precondicionamento Isquêmico ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background: Whole body vibration training (WBV) is a new training program, which is safe and effective. It can be followed by the public. However, data on the safety and efficacy of vibration on myocardial ischemia reperfusion (IR) injury are lacking. Objective: To examine the effect of WBV on the tolerance of the myocardium to acute IR injury in an experimental rat model. Methods: Twenty-four male Wistar rats were divided into control and vibration groups. Vibration training consisted of vertical sinusoidal whole body vibration for 30 min per day, 6 days per week, for 1 or 3 weeks (WBV1 and WBV3 groups, respectively). All the rats were submitted to myocardial IR injury. Myocardial infarct size and ischemia-induced arrhythmias were assessed. Differences between variables were considered significant when p < 0.05. Results: No differences were observed between the groups regarding the baseline hemodynamic parameters. Infarct size was smaller in the experimental group (control, 47 ± 2%; WBV1, 39 ± 2%; WBV3, 37 ± 2%; p < 0.05, vs. control). Vibration produced a significant decrease in the number and duration of ventricular tachycardia (VT) episodes compared to the control value. All ventricular fibrillation (VF) episodes in the vibration groups were self-limited, while 33% of the rats in the control group died due to irreversible VF (p = 0.02). Conclusion: The data showed that vibration training significantly increased cardiac tolerance to IR injury in rats, as evidenced by reduction in the infarct size and cardiac arrhythmias, and by facilitating spontaneous defibrillation.
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- 2018
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116. Tratamiento de Flegmasía Cerúlea Dolens con Trombólisis; Reporte de Caso
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Laura Alejandra Peña, L R Mora Posada, C G Hernández Forero, and F Villegas González
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Trombosis ,edema ,isquemia ,anticoagulantes ,terapia trombolítica ,Science ,Science (General) ,Q1-390 - Abstract
La Flegmasía Cerúlea Dolens es una complicación rara y severa de la trombosis venosa profunda, que se manifiesta clínicamente con edema profuso, dolor y cianosis del miembro inferior afectado. La obstrucción masiva del sistema venoso determina un aumento de la presión de los compartimentos de la extremidad, que finalmente compromete la circulación arterial. Su tratamiento debe ser agresivo para evitar la gangrena y/o la muerte. Presentamos el caso de una paciente atendida en la Clínica La Sagrada Familia, Armenia – Colombia, quien consultó por cuadro clínico de edema progresivo en miembro inferior izquierdo, encontrando cambios isquémicos en falanges distales y edema grado III en miembro inferior izquierdo, con reporte de dúplex venoso con trombosis venosa profunda iliofemoral extensa izquierda y dúplex arterial con reducción de los flujos arteriales secundario a edema severo de tejidos blandos, se indica flebografía con trombólisis venosa por catéter regional en miembro inferior izquierdo con infusión continua de trombolítico. Con respectivos controles angiográficos a las 24 y 48 horas con recanalización del 80% de las venas iliaca, femoral y poplítea, se suspendió infusión y se retiró catéter, continuó anticoagulación con heparina no fraccionada hasta lograr paso a anticoagulación oral con posterior egreso hospitalario dado su evolución satisfactoria.
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- 2018
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117. Opções de tratamento cirúrgico em lesões cutâneas por extravasamento acidental de drogas: experiência do Hospital das Clínicas da Faculdade de Medicina da USP.
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Dimas André Milcheski, Wellington Menezes Mota, Rodolfo Costa Lobato, Araldo Ayres Monteiro Júnior, and Rolf Gemperli
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Doença iatrogênica ,Extravasamento de Materiais Terapêuticos e Diagnósticos ,Isquemia ,Necrose ,Retalhos Cirúrgicos ,Cirurgia Plástica ,Surgery ,RD1-811 - Abstract
RESUMO Objetivo: relatar a experiência da Divisão de Cirurgia Plástica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo no tratamento de lesões cutâneas por extravasamento acidental de drogas. Métodos: foram incluídos os pacientes com lesões por extravasamento de drogas num período de 18 meses. Os seguintes parâmetros foram avaliados retrospectivamente: idade, diagnósticos durante internação e comorbidades, níveis séricos de albumina e hemoglobina, local de internação, droga envolvida, segmento anatômico acometido, conduta terapêutica e óbito durante internação. Resultados: foram acompanhados 14 pacientes. A principal droga envolvida foi a noradrenalina (21%). Todos os pacientes foram submetidos a desbridamento da necrose tecidual. Três pacientes foram submetidos a retalhos após preparo do leito com terapia por pressão negativa, com bons resultados. Sete pacientes não tiveram tratamento definitivo de suas lesões por falta de condições clínicas. Conclusão: o tratamento definitivo por meio de retalhos se mostrou adequado para os casos de feridas por extravasamento de drogas em tecido subcutâneo, quando há exposição de estruturas nobres, em pacientes com condições clínicas favoráveis.
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- 2018
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118. Prior intake of Brazil nuts attenuates renal injury induced by ischemia and reperfusion
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Natassia Alberici Anselmo, Leticia Colombo Paskakulis, Renata Correia Garcias, Fernanda Fortuci Resende Botelho, Giovana Queda Toledo, Maria Fernanda Ribeiro Cury, Natiele Zanardo Carvalho, Glória Elisa Florido Mendes, Tatiane Iembo, Thaís Santana Gastardelo Bizotto, Patricia Maluf Cury, Agnaldo Bruno Chies, and Carla Patrícia Carlos
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Isquemia ,Reperfusão ,Lesão renal aguda ,Estresse oxidativo ,Inflamação ,Castanha-do-brasil ,Ratos ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
ABSTRACT Introduction: Ischemia-reperfusion (IR) injury results from inflammation and oxidative stress, among other factors. Because of its anti-inflammatory and antioxidant properties, the Brazil nut (BN) might attenuate IR renal injury. Objective: The aim of the present study was to investigate whether the intake of BN prevents or reduces IR kidney injury and inflammation, improving renal function and decreasing oxidative stress. Methods: Male Wistar rats were distributed into six groups (N=6/group): SHAM (control), SHAM treated with 75 or 150 mg of BN, IR, and IR treated with 75 or 150 mg of BN. The IR procedure consisted of right nephrectomy and occlusion of the left renal artery with a non-traumatic vascular clamp for 30 min. BN was given daily and individually for 7 days before surgery (SHAM or IR) and maintained until animal sacrifice (48h after surgery). We evaluated the following parameters: plasma creatinine, urea, and phosphorus; proteinuria, urinary output, and creatinine clearance; plasmatic TBARS and TEAC; kidney expression of iNOS and nitrotyrosine, and macrophage influx. Results: Pre-treatment with 75 mg of BN attenuated IR-induced renal changes, with elevation of creatinine clearance and urinary output, reducing proteinuria, urea, and plasmatic phosphorus as well as reducing kidney expression of iNOS, nitrotyrosine, and macrophage influx. Conclusion: Low intake of BN prior to IR-induced kidney injury improves renal function by inhibition of macrophage infiltration and oxidative stress.
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- 2018
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119. Análisis Espacial en la Evaluación de Cambios de la Despolarización Cardíaca durantes Isquemia Aguda de Miocardio
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Romero, D., Ringborn, M., Laguna, P., Pahlm, O., Pueyo, E., Folgueras Méndez, José, editor, Aznielle Rodríguez, Tania Y., editor, Calderón Marín, Carlos F., editor, Llanusa Ruiz, Susana Beatriz, editor, Castro Medina, Jorge, editor, Vega Vázquez, Haddid, editor, Carballo Barreda, Maylen, editor, and Rodríguez Rojas, Rafael, editor
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- 2013
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120. Effects of N-acetylcysteine and pentoxifylline on remote lung injury in a rat model of hind-limb ischemia/reperfusion injury
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Hamed Ashrafzadeh Takhtfooladi, Saeed Hesaraki, Foad Razmara, Mohammad Ashrafzadeh Takhtfooladi, and Hadi Hajizadeh
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Músculo esquelético ,Isquemia ,Traumatismo por reperfusão ,Lesão pulmonar ,Acetilcisteína ,Pentoxifilina ,Diseases of the respiratory system ,RC705-779 - Abstract
Objective : To investigate the effects of N-acetylcysteine (NAC) and pentoxifylline in a model of remote organ injury after hind-limb ischemia/reperfusion (I/R) in rats, the lungs being the remote organ system. Methods : Thirty-five male Wistar rats were assigned to one of five conditions (n = 7/group), as follows: sham operation (control group); hind-limb ischemia, induced by clamping the left femoral artery, for 2 h, followed by 24 h of reperfusion (I/R group); and hind-limb ischemia, as above, followed by intraperitoneal injection (prior to reperfusion) of 150 mg/kg of NAC (I/R+NAC group), 40 mg/kg of pentoxifylline (I/R+PTX group), or both (I/R+NAC+PTX group). At the end of the trial, lung tissues were removed for histological analysis and assessment of oxidative stress. Results : In comparison with the rats in the other groups, those in the I/R group showed lower superoxide dismutase activity and glutathione levels, together with higher malondialdehyde levels and lung injury scores (p < 0.05 for all). Interstitial inflammatory cell infiltration of the lungs was also markedly greater in the I/R group than in the other groups. In addition, I/R group rats showed various signs of interstitial edema and hemorrhage. In the I/R+NAC, I/R+PTX, and I/R+NAC+PTX groups, superoxide dismutase activity, glutathione levels, malondialdehyde levels, and lung injury scores were preserved (p < 0.05 for all). The differences between the administration of NAC or pentoxifylline alone and the administration of the two together were not significant for any of those parameters (p > 0.05 for all). Conclusions : Our results suggest that NAC and pentoxifylline both protect lung tissue from the effects of skeletal muscle I/R. However, their combined use does not appear to increase the level of that protection.
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- 2016
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121. Digital block with or without the addition of epinephrine in the anesthetic solution
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Almiro dos Reis Júnior and Denise Quinto
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Anestesia ,regional ,Anestésicos locais ,cocaína ,lidocaína ,bupivacaína ,ropivacaína ,Cirurgia, dedos de mãos ,Isquemia ,epinefrina ,Anesthesiology ,RD78.3-87.3 - Abstract
BACKGROUND AND OBJECTIVES: Review of various techniques for digital blocks with local anesthetic, with or without epinephrine. CONTENTS: Description of various procedures and comparison of results reported in the literature, mainly on latency and quality of anesthesia, details on vasoconstrictor effect of epinephrine, intraoperative bleeding, necessity of tourniquet use, duration of anesthesia and postoperative analgesia, blood flow and digital SpO2 behavior, local and systemic complications, and also approaches and drugs to be used in certain situations of ischemia. CONCLUSIONS: The advantages of adding epinephrine to the anesthetic solution are minor when compared to the risks of the procedure, and it seems dangerous to use a vasoconstrictor in the fingers, unless the safety of the technique and the possibility of discarding the tourniquet are definitely proven.
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- 2016
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122. Retinal ischemia as the first manifestation of antiphospholipid antibody syndrome.
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Oliveira Ribeiro, Giovanna Maria, Engel Velano, Carlos Eduardo, Cardoso Ribeiro, Cleiton, and de Andrade Oliveira Ribeiro, Flávia Beatriz
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ANTIPHOSPHOLIPID syndrome , *PHOSPHOLIPID antibodies , *ISCHEMIA , *PHYSICIANS , *THROMBOEMBOLISM , *THROMBOSIS - Abstract
Antiphospholipid antibody syndrome (APS) is characterized by the development of venous and/or arterial thrombosis and by gestational morbidity (recurrent fetal losses) in the presence of antiphospholipid antibodies. We report the case of a 38-year-old woman who was diagnosed with primary APS from thromboembolic abnormalities in the retinal periphery that led to retinal ischemia. The aim of this study is to share with physicians and medical undergraduates an atypical manifestation of the syndrome that is the most common acquired thrombophilia, that should be part of the diagnostic routine of all clinical specialties. [ABSTRACT FROM AUTHOR]
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- 2021
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123. Avaliação dos resultados clínicos do tratamento artroscópico de lesões do manguito rotador pela técnica de suture bridge modificada
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Fonseca Filho, João Manoel, Sella, Guilherme do Val, Souza, Luis Henrique Lima de, Miyadahira, Renato, Rosa, João Roberto Polydoro, and Miyazaki, Alberto Naoki
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recidiva ,recurrence ,lesões do manguito rotador ,cicatrização ,suture techniques ,wound healing ,ischemia ,rotator cuff injuries ,isquemia ,técnicas de sutura - Abstract
Objective To evaluate the postoperative clinical outcomes of the arthroscopic repair of rotator cuff injuries using a suture configuration we have developed based on a modification of the Suture Bridge (Arthrex, Naples, FL, United States). Methods A retrospective study with 28 male (41.2%) and 40 female (58.8%) subjects with a mean age of 60 years. All patients underwent rotator cuff repair with the modified Suture Bridge technique and follow-up for a minimum period of 18 months. The clinical assessment was performed using the University of California, Los Angeles (UCLA) Shoulder Score. Results The mean postoperative range of motion was of 134° (range: 110° to 140°) for elevation, 58° (range: 40° to 70°) for lateral rotation, and T10 (range: L4 to T7) for medial rotation. The mean increase was of 15° for elevation, 14° for lateral rotation, and 2 vertebral levels for medial rotation. The outcomes were excellent in 61 (83.6%) cases, good in 8 (10.9%), and regular in 4 cases (5.5%). Conclusion The modified Suture Bridge technique for the arthroscopic repair of rotator cuff injuries led to excellent or good postoperative clinical outcomes in most cases (69; 94.5%). Resumo Objetivo Avaliar os resultados clínicos pós-operatórios do reparo artroscópico de lesões do manguito rotador com uma configuração de sutura desenvolvida por nós a partir de modificação do Suture Bridge (Arthrex, Naples, FL, Estados Unidos). Métodos Estudo retrospectivo de 28 pacientes do gênero masculino (41,2%) e 40 do gênero feminino (58,8%), com média de idade de 60 anos. Todos foram submetidos a reparo do manguito rotador com a técnica Suture Bridge modificada e acompanhados por um período mínimo de 18 meses. Os pacientes foram avaliados clinicamente através da Escala de Ombro da University of California, Los Angeles (UCLA). Resultados A amplitude de movimento média no pós-operatório foi elevação de 134 ° (variação: 110° a 140°), rotação lateral de 58° (variação: 40° a 70°), e rotação medial de T10 (variação: L4 a T7). O aumento médio de elevação foi de 15°, o de rotação lateral, de 14°, e o de rotação medial, de 2 níveis vertebrais. Os resultados foram considerados excelentes em 61 casos (83,6%) e bons, em 8 (10,9%). Em 4 casos (5,5%), o resultado foi regular. Conclusão Os resultados clínicos pós-operatórios do reparo artroscópico de lesões do manguito rotador, pela técnica Suture Bridge modificada, foram excelentes e bons na maioria dos casos (69; 94,5%).
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- 2023
124. Sialometaplasia necrotizante: una entidad simuladora.
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Gutiérrez-Domingo, Álvaro, Toledano-Valero, Pilar, and Olmos-Juárez, Erika
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Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2020
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125. Trombosis aorto-ilíaca en relación con COVID-19: A propósito de un caso.
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F., Sainz-González, A., Martínez-Izquierdo, and A., Abdelkader-Abu-Sneimeh
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ISCHEMIA , *PNEUMONIA , *OXYGEN , *THROMBOSIS , *ANGIOGRAPHY - Abstract
We present a case of acute arterial ischemia in left lower limb due to aortoiliac thrombosis in a patient with SARS-CoV-2 pneumonia with severe respiratory distress. Abdominal CT angiography was performed with high suspect of left iliofemoral and right femoropopliteal compromise without cardioembolic risk factors nor previous intermittent claudication. Despite patient's poor condition, who needed supplementation of high flow oxygen, a salvage surgery was performed in order to preserve the extremity. The intervention was performed under local anesthesia and reverse Trendelenburg position in order to keep appropriate oxygen saturation. The procedure consisted of mechanical iliofemoral thromboembolectomy of the symptomatic limb achieving functional recovery. [ABSTRACT FROM AUTHOR]
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- 2020
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126. Estudo comparativo do Índice Tornozelo-Braquial em diabéticos e não diabéticos com isquemia crítica
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Vanessa Prado dos Santos, Carlos Alberto Silveira Alves, Ronald José Ribeiro Fidelis, Cícero Fidelis, and José Siqueira de Araújo Filho
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diabetes mellitus ,aterosclerose ,isquemia ,Índice Tornozelo-Braquial ,complicações do diabetes ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Resumo Contexto A calcificação da camada média arterial pode tornar o Índice Tornozelo-Braquial (ITB) falsamente elevado em diabéticos, dificultando a avaliação da doença arterial. Objetivo Comparar os valores do ITB de diabéticos e não diabéticos com isquemia crítica. Métodos Foram incluídos 140 pacientes (60% de diabéticos) acompanhados no Serviço de Cirurgia Vascular do Complexo Hospitalar Universitário Professor Edgard Santos com isquemia crítica por DAOP infra-inguinal. Comparou-se a média dos valores do ITB dos dois grupos de pacientes, correlacionando o ITB com a gravidade da isquemia, segundo a Classificação de Rutherford. A análise estatística foi realizada pelo EPI-INFO. Resultados A maioria dos 140 pacientes (77%) se encontrava na Categoria 5 da Classificação de Rutherford, 6% na 4 e 17% na 6. Nove diabéticos (11%) e um não diabético (2%) apresentaram ITB > 1,15 (p = 0,02), sendo excluídos da análise das médias do ITB. Considerando os 130 pacientes, os 75 doentes diabéticos apresentaram média do ITB na artéria tibial posterior de 0,26 versus 0,28 dos 55 doentes não diabéticos (p = 0,6); e no ITB da artéria pediosa aqueles apresentaram média de 0,32 versus 0,23 desses (p = 0,06). Estratificando os doentes nas categorias da Classificação de Rutherford, não houve diferença nas médias do ITB nas categorias 4 e 5. Apenas em relação à artéria pediosa e em pacientes na Categoria 6, a média do ITB foi significativamente maior em diabéticos (0,44 versus 0,16; p = 0,03). Conclusão Os diabéticos apresentaram maior prevalência de ITB falsamente elevado. Porém, excluindo-se esses casos, a média dos valores de ITB são semelhantes aos não diabéticos, exceto na artéria pediosa, nos pacientes com isquemia na categoria 6.
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- 2015
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127. Effect of remote ischemic postconditioning in inflammatory changes of the lung parenchyma of rats submitted to ischemia and reperfusion
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Rafael Cantero Dorsa, José Carlos Dorsa Vieira Pontes, Andréia Conceição Brochado Antoniolli, Guilherme Viotto Rodrigues da Silva, Ricardo Adala Benfatti, Carlos Henrique Marques dos Santos, Elenir Rose Cury Pontes, and José Anderson Souza Goldiano
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Isquemia ,Reperfusão ,Pós-Condicionamento Isquêmico ,Lesão Pulmonar ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
AbstractObjective:To assess the effects of postconditioning remote in ischemia-reperfusion injury in rat lungs.Methods:Wistar rats (n=24) divided into 3 groups: GA (I/R) n=8, GB (R-Po) n=8, CG (control) n=8, underwent ischemia for 30 minutes artery occlusion abdominal aorta, followed by reperfusion for 60 minutes. Resected lungs and performed histological analysis and classification of morphological findings in accordance with the degree of tissue injury. Statistical analysis of the mean rating of the degree of tissue injury.Results:GA (3.6), GB (1.3) and CG (1.0). (GA GB X P
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- 2015
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128. Memory deficit associated with increased brain proinflammatory cytokine levels and neurodegeneration in acute ischemic stroke
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Bruno Silva, Larissa Sousa, Aline Miranda, Anilton Vasconcelos, Helton Reis, Lucíola Barcelos, Rosa Arantes, Antonio Teixeira, and Milene Alvarenga Rachid
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encéfalo ,isquemia ,memória ,inflamação ,citocinas ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
The present study aimed to investigate behavioral changes and neuroinflammatory process following left unilateral common carotid artery occlusion (UCCAO), a model of cerebral ischemia. Post-ischemic behavioral changes following 15 min UCCAO were recorded 24 hours after reperfusion. The novel object recognition task was used to assess learning and memory. After behavioral test, brains from sham and ischemic mice were removed and processed to evaluate central nervous system pathology by TTC and H&E techniques as well as inflammatory mediators by ELISA. UCCAO promoted long-term memory impairment after reperfusion. Infarct areas were observed in the cerebrum by TTC stain. Moreover, the histopathological analysis revealed cerebral necrotic cavities surrounded by ischemic neurons and hippocampal neurodegeneration. In parallel with memory dysfunction, brain levels of TNF-a, IL-1b and CXCL1 were increased post ischemia compared with sham-operated group. These findings suggest an involvement of central nervous system inflammatory mediators and brain damage in cognitive impairment following unilateral acute ischemia.
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- 2015
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129. Transfusões de sangue no choque séptico: 7,0g/dL é mesmo o limite adequado?
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Bruno Franco Mazza, Flavio Geraldo Rezende Freitas, Melca Maria Oliveira Barros, Luciano Cesar Pontes Azevedo, and Flavia Ribeiro Machado
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Transfusão de eritrócitos ,Isquemia ,Choque séptico ,Sepse ,Oxigenação ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Objetivo: Avaliar os efeitos imediatos da transfusão de hemácias nos níveis de saturação venosa central de oxigênio e de lactato em pacientes com choque séptico usando diferentes níveis gatilho de hemoglobina para indicar transfusão. Métodos: Incluímos pacientes com diagnóstico de choque séptico nas últimas 48 horas e níveis de hemoglobina abaixo de 9,0g/dL. Os pacientes foram randomizados para receber imediatamente transfusão se as concentrações se mantivessem acima de 9,0g/dL (Grupo Hb9) ou adiar a transfusão até que a hemoglobina caísse abaixo de 7,0g/dL (Grupo Hb7). Os níveis de hemoglobina, lactato e saturação venosa central de oxigênio foram determinados antes e 1 hora após cada transfusão. Resultados: Incluímos 46 pacientes, totalizando 74 transfusões. Os pacientes do Grupo Hb7 tiveram uma redução significante nos níveis medianos de lactato de 2,44 (2,00 - 3,22) mMol/L para 2,21 (1,80 - 2,79) mMol/L; p = 0,005. Isto não foi observado no Grupo Hb9 [1,90 (1,80 - 2,65) mMol/L para 2,00 (1,70 - 2,41) mMol/L; p = 0,23]. A saturação venosa central de oxigênio aumentou no Grupo Hb7 [68,0 (64,0 - 72,0)% para 72,0 (69,0 - 75,0)%; p < 0,0001], mas não no Grupo Hb9 [72,0 (69,0 - 74,0)% para 72,0 (71,0 - 73,0)%; p = 0,98]. Pacientes com elevados níveis de lactato ou saturação venosa central de oxigênio menor que 70% na avaliação basal tiveram um aumento significante nessas variáveis, independentemente dos níveis basais de hemoglobina. Pacientes com valores normais não demonstraram diminuição em quaisquer dos grupos. Conclusão: A transfusão de hemácias aumentou a saturação venosa central de oxigênio e diminuiu os níveis de lactato em pacientes com hipoperfusão, independentemente de seus níveis basais de hemoglobina. A transfusão não pareceu influenciar essas variáveis em pacientes sem hipoperfusão. ClinicalTrials.gov NCT01611753
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- 2015
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130. Naringin attenuated cardiac ischemia–reperfusion injury by mechanisms involving the anti-apoptotic pathway and KATP action
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Araujo, Andreza Melo de and Vasconcelos, Carla Maria Lins de
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Isquemia ,Naringina ,Myocardial ischemia ,Antioxidantes ,Antiapoptótica ,Antioxidant ,FISIOLOGIA [CIENCIAS BIOLOGICAS] ,Reperfusão miocárdica ,Flavonoides ,Isquemia miocárdica ,Naringin ,KATP ,Anti-apoptotic - Abstract
Introduction: acute myocardial infarction (AMI) remains with high morbidity and mortality rates and occurs mainly due to reduced blood flow due to atherosclerotic plaque leading to ischemia. Although reperfusion is the main clinical intervention, it exacerbates damage initiated during ischemia. Therefore, natural products have been studied for the prevention and treatment of AMI. Naringin (NRG) is a flavonoid found in citrus fruits with recognized cardioprotection against atherosclerosis, coronary disease, hypertension, cardiac hypertrophy, AMI and ischemic stroke. Objective: to elucidate the mechanism of NRG in cardioprotection against IR injury. Methods: in isolated hearts of Wistar rats, the effects of NRG (5 and 10 µM) on contractile and electrocardiographic variables were evaluated. Isolated hearts were perfused with NRG (5 µM) or NRG with glibenclamide (GLI, 10 µM, a non-specific blocker of KATP channels) and subjected to global ischemia (30 min) and reperfusion (60 min). The area of infarction, tissue injury through the release of lactate dehydrogenase (LDH), index and occurrence of arrhythmias and contractile variables were evaluated. In animals pre-treated for 7 days (NRG 25 mg/kg or N-acetyl cysteine 100 mg/kg) and submitted to the IR protocol, the expression of Bax, Blc-2, SOD CuZn and SOD Mn were evaluated. In addition, citrate synthase activity and histological changes were analyzed. Results: When NRG was perfused at 5 or 10 µM concentrations, it did not change contractile and electrocardiographic variables in isolated hearts. The cardioprotective effect of NRG (5 µM) was abolished in the presence of GLI, since there was a decrease in LVDP, an increase in tissue injury (LDH) and infarcted area, an increase in the rate of arrhythmias and in the occurrence of more severe arrhythmias (tachycardia and ventricular fibrillation). In animals treated with NRG and submitted to IR, there was a decrease in Bax expression and in the Bax/Bcl-2 ratio compared to the vehicle + IR group. There was no alteration in the expression of SOD CuZn and SOD Mn among the four groups studied, in addition, in the hearts of animals pre-treated with NRG there was an increase in citrate synthase activity. Histopathological analysis showed that NRG decreased intracellular and interstitial edema and prevented changes in nuclear and cytoplasmic diameter. Conclusion: this study demonstrates that NRG has a cardioprotective effect against cardiac IR injury mediated by its anti-apoptotic, antiarrhythmic action and probable activation of KATP. In addition, it provides subsidies for future studies that can ensure the use of medicinal plants, natural products and foods rich in NRG in cardioprotection against AMI. Introdução: o infarto agudo do miocárdio (IAM) permanece com altas taxas de morbimortalidade e ocorre, principalmente, por redução do fluxo sanguíneo em virtude de placa de ateroma levando à isquemia. Embora a reperfusão seja a principal intervenção na clínica, ela exacerba os danos iniciados durante a isquemia. Sendo assim, produtos naturais tem sido alvo de estudo para prevenção e tratamento do IAM. A naringina (NRG) é um flavonoide encontrado em frutas cítricas com reconhecida cardioproteção contra aterosclerose, doença coronariana, hipertensão, hipertrofia cardíaca, IAM e acidente vascular cerebral isquêmico. Objetivo: elucidar os mecanismos da NRG na cardioproteção frente à injúria de IR. Métodos: em coração isolado de ratos Wistar foram avaliados os efeitos da NRG (5 e 10 µM) sobre variáveis contráteis e eletrocardiogáficas. Corações isolados foram perfundidos com NRG (5 µM) ou NRG com glibenclamida (GLI, 10 µM, um bloqueador não-específico dos canais KATP) e submetidos a isquemia global (30 min) e reperfusão (60 min). Foram avaliados área de infarto, lesão tecidual por meio da liberação da lactato desidrogenase (LDH), índice e ocorrência de arritmias e variáveis contráteis. Em animais pré-tratados por 7 dias (NRG 25 mg/kg ou N-acetil cisteína 100 mg/kg) e, submetidos ao protocolo de IR, foram avaliados a expressão da Bax, Blc-2, SOD CuZn e SOD Mn. Além disso, analizou-se a atividade da citrato sintase e alterações histológicas. Resultados: A NRG quando perfundida nas concentrações de 5 e 10 µM não alterou as variáveis contráteis e eletrocardiográficas em coração isolado. O efeito cardioprotetor da NRG (5 µM) foi abolido na presença de GLI, uma vez que houve diminuição da PDVE, aumento da injúria tecidual (LDH) e área de infarto, aumento do índice de arritmias e da ocorrência de arritmias mais graves (taquicardia e fibrilação ventricular). Nos animais tratados com a NRG e submetidos a IR, houve diminuição da expressão da Bax e da razão Bax/Bcl-2 em comparação ao grupo veículo + IR. Não houve alteração da expressão da SOD CuZn e SOD Mn entre os quatro grupos estudados, além disso, nos corações dos animais pré-tratados com a NRG houve um aumento da atividade da citrato sintase. A análise histopatológica mostrou que a NRG diminuiu o edema intracelular e intersticial e preveniu alterações no diâmetro nuclear e citoplasmático. Conclusão: este estudo demonstra que a NRG possui efeito cardioprotetor contra a injúria de IR cardíaca mediada por sua ação antiapoptótica, antiarrítmica e provável ativação de KATP. Além disso, fornece subsídios para futuros estudos que possam assegurar o uso de plantas medicinais, produtos naturais e alimentos ricos em NRG na cardioproteção contra o IAM. São Cristóvão
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- 2022
131. Oclusión total de la arteria coronaria derecha y disfunción de la arteria del nodo sinoatrial.
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Gopar-Nieto, Rodrigo, González-Negrete, Eduardo, Loáisiga-Sáenz, Arnoldo Enmanuel, Chávez-Gómez, Nancy Libertad, Carazo-Vargas, Gonzalo, Montes-Isunza, Héctor Emilio, and Raymundo-Martínez, Grecia Iveth Maryelis
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The sinus node artery irrigates the main pacemaker of the heart and its occlusion or damage can generate arrhythmias. We reported the case of a patient that had an inferior myocardial infarction due to total thrombotic occlusion of the proximal right coronary artery, atrial premature beats and an atrioventricular block. We described the 6 routes that the sinus node artery can follow and the different clinical manifestations that can be observed if occluded. Prevalence studies should be conducted to determine the distribution of this artery in the Mexican population, and to be able to predict rhythm disorders with a higher probability. [ABSTRACT FROM AUTHOR]
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- 2019
132. Infarto cerebelar após orquidopexia sob raquianestesia.
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Goel, Sunny, Garg, Gaurav, Kumar, Manoj, and Aeron, Ruchir
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Copyright of Revista Brasileira de Anestesiologia is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2019
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133. Valor predictivo de la procalcitonina para la necesidad de cirugía y la presencia de isquemia y necrosis en pacientes con obstrucción del intestino delgado.
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Evaristo-Méndez, Gerardo, Gallegos-Sierra, Cuauhtly, and De La Cruz-Temores, Salvador
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Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2019
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134. Are there differences in auscultatory pulse in total blood flow restriction between positions, limbs and body segments?
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Rodrigues Neto, Gabriel, Silva, Júlio C. G., Umbelino, Rammily K. C., Silva, Hidayane G., Neto, Elísio A. P., Oliota-Ribeiro, Leandro S., Bittar, Simoni T., and Cirilo-Sousa, Maria S.
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ANTHROPOMETRY ,BLOOD circulation ,EXTREMITIES (Anatomy) ,HEMODYNAMICS ,SEX distribution ,BODY movement ,DESCRIPTIVE statistics ,EVALUATION ,PHYSIOLOGY - Abstract
Copyright of Brazilian Journal of Kineanthropometry & Human Performance is the property of Brazilian Journal of Kineanthropometry & Human Performance and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2018
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135. Establishment of an experimental model of small intestinal ischemia and reperfusion injuries in New Zealand rabbits.
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Oliveira, Alvaro P. L., Rangel, Julia P. P., Riodades, Luiz F. S., Almeida, Bruna L., Mathias, Carlos Henrique T., Conti, Laura M. C., Fiorio, Wagner A. B., and Monteiro, Betânia S.
- Abstract
Copyright of Pesquisa Veterinaria Brasileira is the property of Colegio Brasileiro de Patologia Animal - CBPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2018
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136. GLOSSECTOMIA PARCIAL EM EQUINOS: RELATO DE DOIS CASOS.
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DIAS, Deborah Penteado Martins, ROCHA, Anita dos Santos, TEIXEIRA, Luisa Gouvêa, SOUSA, Samuel dos Santos, and MONTELLO-NETO, Joel de Souza
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Despite oral soft tissues have a fast healing ability, surgical treatment for tongue disorders is indicated aiming to save function and cosmetic appearance. The cases of two mares presenting hiporexia from tongue lesions, one laceration and one due to tongue ischemia were described. The first mare was undergone surgery for partial glossectomy and the second one received medical treatment until the devitalized lingual stump could be removed by traction. Both mares experienced temporary difficulty while eating during healing process, however recovery was faster following surgery. [ABSTRACT FROM AUTHOR]
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- 2018
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137. Tratamiento de Flegmasía Cerúlea Dolens con Trombólisis; Reporte de caso.
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Peña, Peralta L. A., Mora, Posada L. R., Hernández G., Forero C. G., and Villegas González, F.
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EDEMA ,VENOUS thrombosis ,LEG ,FEMORAL vein ,VENOGRAPHY ,CYANOSIS ,PHALANGES - Abstract
Copyright of Revista Cuarzo (REC) is the property of Fundacion Universitaria Juan N. Corpas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2018
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138. Angina abdominal: aspectos clínico-terapéuticos.
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Siavichay Ochoa, Tanya Fernanda, Lema Knezevich, Ricardo Antonio, Guartizaca Durán, Vanessa Alexandra, Román Sarango, José Miguel, Criollo Tepan, Juan Diego, and Puchaicela Godoy, María Gabriela
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Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2018
139. Sobre el mal de los ardientes o del fuego de San Antonio.
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RAMÍREZ-QUINTERO, JUAN DAVID
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Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2018
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140. Angina mesentérica en un paciente con linfoma de colon y adenocarcinoma prostático.
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Aguilera-Zárate, Raúl, Guerrero-Hernández, Juan Miguel, and Reneé-Soto, Dulce
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Mesenteric angina is a syndrome caused by inadequate perfusion from the mesenteric vessels, resulting in ischemia and eventually gut necrosis. Although relatively rare, it is a potential deadly condition. We report a case of mesenteric ischemia which began with bloating, postprandial pain and weight loss on a patient previously diagnosed and treated from colonic lymphoma and prostatic adenocarcinoma. [ABSTRACT FROM AUTHOR]
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- 2018
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141. Angina and Ischemia at 2 Years With Bioresorbable Vascular Scaffolds and Metallic Drug-eluting Stents. ESTROFA Ischemia BVS-mDES Study.
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de la Torre Hernández, José M., Rumoroso, José R., Ojeda, Soledad, Brugaletta, Salvatore, Cascón, José D., Ruisánchez, Cristina, Sánchez Gila, Joaquín, Roa, Jessica, Tizón, Helena, Gutiérrez, Hipólito, Larman, Mariano, García Camarero, Tamara, Pinar, Eduardo, Díaz, José F., Pan, Manuel, Morillas Bueno, Miren, Oyonarte, José M., Ruiz Guerrero, Luis, Ble, Mireia, and Rubio Patón, Ramón
- Abstract
Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2018
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142. Variação barométrica do balonete do tubo endotraqueal preenchido com ar ambiente ou lidocaína durante manutenção anestésica com óxido nitroso.
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de Carli, Daniel, Meletti, José Fernando Amaral, de Araújo Miranda, César, Netto, Jorge Augusto Pereira, de Brito, Sérgio Henrique Palmeira, and Silvat, Tiago Silva e.
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- 2018
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143. EFEITO DO PROTOCOLO DE ISQUEMIA PRÉ-CONDICIONANTE NA PERFORMANCE DA POTÊNCIA DE MEMBROS INFERIORES EM ATLETAS DE HANDEBOL.
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Montenegro, Vanessa, Barbosa Pereira Lemos, Luís Filipe Gomes, and Medeiros Lima, Leonardo Emmanuel
- Abstract
Copyright of Revista Brasileira de Prescrição e Fisiologia do Exercício is the property of Instituto Brasileiro de Pesquisa e Ensino em Fisiologia do Exercicio and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2018
144. Ischemia and perioperative infarction.
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Navarro-Vargas, José Ricardo and García Borrero, Luís Mauricio
- Abstract
Copyright of Colombian Journal of Anesthesiology is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2018
- Full Text
- View/download PDF
145. Revascularização no Pé Diabético: Caso Clínico
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Ana Sofia de Sá Monteiro Gil Pinheiro, Daniel Brandão, Paulo Barreto, Joana Ferreira, José Almeida Lopes, Joel Sousa, and Armando Mansilha
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Amputação ,Complicações da Diabetes ,Doença Arterial Obstrutiva ,Isquemia ,Pé Diabético ,Procedimentos Endovasculares ,Medicine ,Medicine (General) ,R5-920 - Abstract
Em Portugal, a prevalência da diabetes mellitus é cerca de 13,3%. Uma das complicações da diabetes é a amputação. Destas, 70% são precedidas de uma úlcera. Apresentamos o caso de um doente do sexo masculino de 46 anos de idade, fumador, com antecedentes de diabetes mellitus não controlada, que recorreu ao serviço de urgência por uma úlcera no pé direito com cerca de dois meses de evolução. Foi internado com o diagnóstico de pé diabético neuroisquémico, para controlo de infeção, analgesia e revascularização. Consideramos o caso clínico pertinente dada a prevalência crescente de diabetes mellitus e da doença arterial obstrutiva periférica. Salienta-se a importância da instituição de tratamento precoce, em particular da revascularização e do controlo da infeção, o que conduzirá à diminuição da taxa de amputações major. Recebido: 30/10/2017 - Aceite: 29/11/2017
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- 2018
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146. Mielite transversa aguda - relato de caso: Acute transverse myelitis - case report
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Eder Cruz De Sousa, Wilson Tomaz Da Silva Júnior, Letícia Matos Gonçalves, Sarah Barreto Pinheiro Souza Pinto, Anamaria Camargo Macedo, and Marcos Masini
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General Medicine ,isquemia ,mielite transversa - Abstract
Este relato de caso tem uma abordagem estritamente científica, sem conflitos de interesses e respeita as múltiplas facetas éticas. Visa analisar um caso clínico de Mielite Transversa Aguda e suas repercussões para o paciente. A pesquisa se baseia no laudo médico final e dados de prontuário relacionados com a evolução do tratamento. A nosso ver, acrescentar elementos desconhecidos pela literatura atual promove novas evidências científicas que certamente trarão benefícios aos futuros pacientes e à comunidade.
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- 2022
147. Diagnóstico e manejo de isquemia aguda de membro em paciente pós infecção viral por covid-19: série de casos
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Teixeira, Jamisson Garrote, Pitta, Guilherme Benjamin Brandão, Silva, Cézar Ronaldo Alves da, Teixeira, Lucigl Regueira, Panazzolo, Gregório Luís Guarnieri, Sampaio, Joaquim Araújo, Sousa, Anna Karoline Rocha de, and Moura, Claubiano Cipriano
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anticoagulants ,covid-19 ,extremidade inferior ,lower limb ,anticoagulantes ,isquemia ,ischemia ,upper limb ,trombose ,extremidade superior ,thrombosis - Abstract
Resumo A pandemia causada pela doença do coronavírus 2019 (covid-19) estabeleceu desafios e estimulou o desenvolvimento de diferentes formas terapêuticas em várias áreas médicas. Estudos descreveram características clínicas e desfechos de pacientes, incluindo desordens do sistema de coagulação, em que os pacientes infectados pelo vírus apresentam um estado de hipercoagulabilidade e pró-inflamatório que mimetiza uma vasculite. O objetivo deste trabalho foi descrever o quadro clínico e a terapia empregada em uma série de três pacientes que evoluíram com quadro de oclusão arterial aguda no período pós-infecção por covid-19. O manejo aplicado nesses casos permitiu que os pacientes evoluíssem sem sequelas. A baixa incidência e a pobreza em relatos descritos tornam difícil o estabelecimento de critérios e opções terapêuticas universalmente aceitos nos casos de isquemia, seja precoce ou tardia, dos pacientes infectados pelo novo coronavírus. Abstract The Covid-19 pandemic caused by the Sars-Cov-2 virus created challenges and stimulated development of new forms of treatment in many different areas of medicine. Studies have described the clinical characteristics of patients and their outcomes, including disorders affecting the coagulation system, in which patients infected by the virus enter a hypercoagulable and proinflammatory state that mimics vasculitis. The objective of this study was to describe the clinical status and the treatment administered to three patients who developed acute arterial occlusion after Covid-19 infection. The management adopted in these cases enabled the patients to recover without sequelae. The low incidence and scarcity of published reports make it difficult to establish universally accepted treatment criteria and options for cases of ischemia in patients infected with the novel coronavirus, whether presenting early or late.
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- 2022
148. Neuroprotective effect of sarcosine in an animal model of focal brain ischemia
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Marques, Bruno Lemes, Pinto, Mauro Cunha Xavier, Vitorino, Fernanda Giachini, and Castro, Célio José de
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Isquemia ,Neuroproteção ,Sarcosine ,FARMACOLOGIA::FARMACOLOGIA GERAL [CIENCIAS BIOLOGICAS] ,Sarcosina ,Neuroprotection ,Schemia - Abstract
O AVE (Acidente Vascular Encefálico) é caracterizado por uma perturbação no fornecimento de sangue cerebral, levando à privação de oxigênio e glicose ao tecido. A isquemia cerebral envolve uma liberação aumentada de glutamato, ativação anormal de NMDAR (receptores de N-Metil-D-Aspartato), e excitotoxicidade. O transportador de glicina tipo 1 (GlyT1) modula a neurotransmissão glutamatérgica através de receptores NMDA, sugerindo uma estratégia terapêutica alternativa para o AVE. Este trabalho investigou o potencial neuroprotetor e de reparo neuronal da inibição de GlyT1 num modelo de isquemia focal em camundongos. Camundongos Swiss submetidos à oclusão permanente da artéria cerebral média (MCAO) foram randomicamente selecionados para receber três doses diferentes de Sarcosina (125, 250, e 500 mg/kg, injeção intraperitoneal) ou veículo antes ou depois da isquemia. O prétratamento com 250 e 500 mg/kg de sarcosina levou à neuroprotecção contra o AVE, como demonstrado pela redução da área de infarto e déficits neurológicos. Além disso, as vias de GluN2A/CaMKIV/CREB e BDNF/TrKB/Akt/mTOR foram estimuladas pela sarcosina. A neuroproteção da sarcosina está também relacionada com a diminuição da atividade da subunidade GluN2B e com uma diminuição da fosforilação de CaMKIIα. Portanto, a neuroproteção induzida pela sarcosina ocorre através da via de BDNF/TRKB e CaMKIV/CREB, ambos os processos desencadeados pela atividade de NMDAR. Stroke is characterized by a disruption in the cerebral blood supply, leading to oxygen and glucose deprivation to the tissue. Cerebral ischemia involves enhanced glutamate release, abnormal NMDAR activation, and excitotoxicity. Glycine transporter type 1 (GlyT1) modulates glutamatergic neurotransmission through NMDA receptors, suggesting an alternative stroke therapeutic strategy. This work investigated the neuroprotective and neurorestorative potential of GlyT1 inhibition in a mouse model of focal ischemia. Swiss mice subjected to permanent middle cerebral artery occlusion (MCAO) were randomized to receive three different doses of Sarcosine (125, 250, and 500 mg/kg) or vehicle before or after ischemia. Pretreatment with 250 and 500 mg/kg of Sarcosine led to neuroprotection against stroke, as demonstrated by reduction of infarct area and neurological deficits. Moreover, GluN2A/CaMKIV/CREB and BDNF/TrKB/Akt/mTOR pathways were enhanced by sarcosine. The sarcosine neuroprotection is also related to GluN2B subunit downregulation and a decrease in CaMKIIα phosphorylation. Additionally, we observed that post-stroke treatment with higher doses of Sarcosine improves the neurorepair process, which is evidenced by the marked reduction of the infarct area and motor deficits. Therefore, sarcosine pretreatment induced neuroprotection through the BDNF/TRKB and CaMKIV/CREB pathways, both processes trigged by NMDAR activity. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
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- 2022
149. Coronary Tortuosity as a New Phenotype for Ischemia without Coronary Artery Disease
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André Estrada, André Silveira Sousa, Claudio Tinoco Mesquita, and Humberto Villacorta
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Isquemia ,Ischemia ,Myocardial Ischemia ,Cardiology and Cardiovascular Medicine ,Coronary Vessels ,Vasos Coronários ,Isquemia Miocárdica - Abstract
Resumo Fundamento As artérias coronárias tendem a ser mais tortuosas que outras artérias e acompanham os movimentos repetidos de flexão e relaxamento que ocorrem durante o ciclo cardíaco. A Tortuosidade das artérias Coronárias (TCor) causa alterações no fluxo coronariano, com uma redução na pressão de perfusão distal, o que pode levar à isquemia miocárdica. Objetivo Avaliar a associação entre TCor e isquemia miocárdica. Métodos Entre janeiro de 2015 e dezembro de 2017, 57 pacientes com angina e doença arterial coronariana não obstrutiva pela angiografia coronária invasiva (ACI) foram incluídos retrospectivamente. Variáveis angiográficas foram analisadas para avaliar a presença e grau de tortuosidade e correlacionadas com seus respectivos territórios vasculares na cintilografia de perfusão miocárdica com estresse. A TCor foi definida como artérias coronárias com três ou mais curvaturas com ângulos ≤ 90o, medidos durante diástole. Um nível de 5% foi estabelecido como estatisticamente significativo. Um nível de 5% foi definido como estatisticamente significativo. Resultados Um total de 17 homens e 40 mulheres foram incluídos (idade média de 58,3 anos). A TCor foi observada em 16 pacientes (28%) e em 24 das 171 artérias. Observou-se uma associação significativa entre TCor e isquemia na análise por artéria (p
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- 2022
150. Protective role of polyethylene glycol 35 against hepatic cold and warm ischemia
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Silva, Rui Gonçalo Teixeira da, Roselló Catafau, Juan, Palmeira, Carlos, and Universitat de Barcelona. Facultat de Biologia
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Ciències de la salut ,Reperfusió (Fisiologia) ,Ischemia ,Malalties del fetge ,Isquèmia ,Medical sciences ,Mitocondris ,Liver diseases ,Reperfusion (Physiology) ,Mitochondria - Abstract
[eng] Steatotic livers are considerably more prone to IRI, in which turn, it is known to impair mitochondrial function. Our working hypothesis lies on the fact that impaired mitochondrial function and reduced protection against oxidative stress are increased risk of complications of hepatic surgery in NAFLD patients. Thus, the main challenges in this field are based on the identification of new pharmacological interventions for enhancing hepatic mitochondrial function and capacity for a better clinical outcome of hepatectomy. The main objective of this doctoral thesis is evaluating the possible protective role of PEG35 against hepatic cold and warm ischemia using different experimental models, more specifically: 1- Understand the role that PEG35 plays in the IGL solutions. In particular, we analyzed the efficacy of fatty liver cold storage using three solution, IGL-0, IGL-1 and IGL-2 containing 0 g/L, 1g/L and 5 g/L of PEG35, respectively (Study 1). 2- Explore a possible synergetic effect on the mitochondria, where PEG35 could enhance HOPE protection, by using the new IGL-2 solution (Study 2). 3- Highlight the use of PEG35-containing solutions as a key factor for hepatic and mitochondrial protection (Study 3). 4- Investigate the utility of PEG35 pharmacological intervention to decipher the mechanisms underlying PEG35 preconditioning-induced protection against IRI, using a model of hypoxia/reoxygenation injury in human hepatoma cell line (Study 4).
- Published
- 2022
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