A complexa fisiopatologia dos episódios vasooclusivos na anemia falciforme

Hemolytic anemia and vasoocclusion are the cardinal clinical features of sickle cell anemia. Vasoocclusion is a complex process involving not only the polymerization of deoxygenated sickle hemoglobin tetramers, but also interactions between sickle erythrocytes, vascular endothelium, platelets, leukocytes, and plasma proteins. The increased adherence of sickle erythrocytes to endothelium has been implicated as an early step in vasoocclusion. Other researchers have focused on leukocytes and platelets which might also contribute to disturbed blood flow. Microvascular occlusion results in acute painful crises, whereas macrovascular occlusion seems to be the cause of organ failure. The anemia results from the markedly shortened circulatory survival of sickle erythrocytes, together with a limited erythropoietic response. The erythropoiesis increases intensively, but it is not enough to balance the increased rate of erythrocytes destruction to maintain normal levels of total erythrocytes and hemoglobin concentrations; mainly by the low oxygen affinity of hemoglobin S and increased 2,3-Diphosphoglycerate. It is very difficult to separate processes leading to anemia or to vasoocclusion. Understanding the involvement of multiple blood componentes in vasoocclusion may elucidate the clinical manifestations and complications of sickle cell anemia, and may give new insights into the preventive and curative therapy.

Effect of Er,Cr:YSGG and Er:YAG laser irradiation on the adhesion of blood components on the root surface and on root morphology

The aim of this study was to conduct an in vitro evaluation, by scanning electron microscopy (SEM), of the adhesion of blood components on root surfaces irradiated with Er,Cr:YSGG (2.78 mu m) or Er:YAG (2.94 mu m) laser, and of the irradiation effects on root surface morphology. Sixty samples of human teeth were previously scaled with manual instruments and divided into three groups of 20 samples each: G1 (control group) - no treatment; G2 - Er,Cr:YSGG laser irradiation; G3 - Er:YAG laser irradiation. After performing these treatments, blood tissue was applied to 10 samples of each group, whereas 10 samples received no blood tissue application. After performing the laboratory treatments, the samples were observed under SEM, and the resulting photomicrographs were classified according to a blood component adhesion scoring system and root morphology. The results were analyzed statistically (Kruskall-Wallis and Mann Whitney tests, alpha = 5%). The root surfaces irradiated with Er:YAG and Er,Cr:YSGG lasers presented greater roughness than those in the control group. Regarding blood component adhesion, the results showed a lower degree of adhesion in G2 than in G1 and G3 (G1 x G2: p = 0.002; G3 x G2: p = 0.017). The Er:YAG and Er,Cr:YSGG laser treatments caused more extensive root surface changes. The Er:YAG laser treatment promoted a greater degree of blood component adhesion to root surfaces, compared to the Er,Cr:YSGG treatment.

Effects of Er,Cr:YSGG Laser Irradiation on Root Surfaces for Adhesion of Blood Components and Morphology

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Red blood cell transfusions in the neonate

Despite recent trends to decrease allogeneic red blood cell (RBC) transfusion thresholds, such transfusions remain an important supportive and life-saving intervention for neonatal intensive care patients. In neonates, apart from concerns about transfusionassociated infections, many controversial questions regarding transfusion practices remain unanswered. Moreover, neonates present specific clinical and immunologic characteristics that require selected blood component products. This article addresses many of these issues from a medical perspective, with emphasis on the best blood banking techniques to provide RBC products for neonatal transfusions. Copyright © 2011 by the American Academy of Pediatrics.

Uso do curativo bio-ativo em pacientes com feridas de origem multifatorial

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Influência das alterações físicas e químicas sobre a função plaquetária e a expressão da GPIIbIIa em concentrados de plaquetas caninos estocados

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Serum magnesium levels in healthy dogs submitted to the administration of cisplatin with fluid therapy

Cisplatin is an antineoplastic drug that is used to treat carcinomas and osteosarcomas in dogs. However, it can cause kidney damage which in turn leads to the loss of electrolytes. Concentration of magnesium was evaluated in the blood serum of eight dogs that had undergone therapy with cisplatin. The dogs were divided into two groups. Group 1 was supply with cisplatin (70 mg/m(2), iv) and to prevent nephrotoxcity, saline solution at 0.9% was administered (25 ml/kg/hour, iv in three hours). The animals in Group 2 were not supplied with cisplatin. There was no significant difference (P < 0.05) between the two groups and the results obtained indicated that the protocol used for Group 1 did not cause changes in the serum concentrations of magnesium. Therefore, it can be concluded that the administration of cisplatin does not cause variations if it is combined with the fluid therapy.

Evaluation of the hemogram in healthy canines under cisplatin therapy

Objective. To evaluate the average values of the hemogram test in healthy dogs during chemotherapy with cisplatin. Materials and methods. The hemogram parameters of eight healthy canines, which underwent therapy with cisplatin, were evaluated. These canines were divided into two groups. The dogs in the first group were given cisplatin (70mg/m(2), i.v.) and to prevent kidney poisoning they were given physiological serum at 0.9% (25mL/kg/h, i.v.). The dogs in group two were not given cisplatin. Results. The hemogram of the dogs in the first group did not show any significant difference (p>0.05) as compared to the dogs in group 2.Conclusions. The data obtained indicate the protocol used with cisplatine does not significantly alter the average values of the hemogram test and the number of chemotherapy sessions increases the risk of diminishing the values of the hemogram test.

Ultrastructural analysis of the low level laser therapy effects on the lesioned anterior tibial muscle in the Gerbil

Low level laser therapy (LLLT) is known for its positive results but studies on the biological and biomodulator characteristics of the effects produced in the skeletal muscle are Still lacking. In this Study the effects of two laser dosages, 5 or 10 J/cm(2), on the lesioned tibial muscle were compared. Gerbils previously lesioned by 100 g load impact were divided into three groups: GI (n = 5) controls, lesion non-irradiated; GII (n = 5), lesion irradiated with 5 J/Cm(2) and GIII (n = 5), lesion irradiated with 10 J/cm(2), and treated for 7 consecutive days with a laser He-Ne (lambda = 633 rim). After intracardiac perfusion, the muscles were dissected and reduced to small fragments, post-fixed in 1% osmium tetroxide, dehydrated in increasing alcohol concentrations, treated with propylene oxide and embedded in Spurr resin at 60 degrees C. Ultrafine Cuts examined on a transmission electron microscope (Jeol 1010) revealed in the control GI group a large number of altered Muscle fibers with degenerating mitochondria, intercellular substance containing degenerating cell fragments and budding blood capillaries with Underdeveloped endothelial cells. However, groups GII and GIII showed muscle fibers with few altered myofibrils, regularly contoured mitochondria, ample intermembrane spaces and dilated mitochondrial crests. The clean intercellular Substance showed numerous collagen fibers and capillaries with multiple abluminal processes, intraluminal protrusions and several pinocytic vesicles in endothelial cells. it was concluded that laser dosages of 5 or 10 J/cm(2) delivered by laser He-Ne (lambda = 633 rim) during 7 consecutive days increase mitochondrial activity in muscular fibers, activate fibroblasts and macrophages and stimulate angiogenesis, thus suggesting effectivity of laser therapy tinder these experimental conditions. (C) 2009 Elsevier Ltd. All rights reserved.

Overall-Mouth Disinfection by Photodynamic Therapy Using Curcumin

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Mast cell and eosinophils in the wall of the gut and eosinophils in the blood stream during Toxocara vitulorum infection of the water buffalo calves (Bubalus bubalis)

Toxocara vitulorum is a pathogenic nematode from the small intestine of very young buffalo calves. To understand the development of the inflammatory responses in the wall of the gut, samples of tissues were removed from the duodenum, jejunum and ileum of buffalo calves naturally infected with T. vitulorum during the beginning of the infection, at the peak of egg output, as well as during the periods of rejection of the worms and post-rejection. Two additional control groups of uninfected calves (by anti-helminthic therapy of their mothers and after the birth) were also necropsied on days 30 and 50 after birth. Blood samples were fortnightly collected from birth to 174 days post-birth. Blood smears were prepared and stained with Giemsa for eosinophils. The parasitological status of buffalo calves was evaluated through weekly fecal egg counts (EPG) from 1 to 106 days after birth, which revealed that T. vitulorum egg shedding started on day 11, reached the peak of the infection on day 49 and finally expelled the parasites between days 50 and 85 after birth. In the infected buffalo calves, the mast cell population increased significantly, by two-fold in the mucosa (villus-crypt unit (VCU)) of the duodenum and four-fold in the proximal jejunum; but these increases were statistically significant only at the peak of the infection. Although mast cell numbers increased in the mucosa of the ileum as well as in both the submucosal and muscle tissues of the duodenum, proximal jejunum and ileum, the data was not significantly different from the controls. Eosinophil numbers increased in the mucosa of the duodenum (two-five times higher than the control) and proximal jejunum (three-five-fold) during the period of the infection (beginning, peak and rejection). The relative numbers of eosinophils increased in the blood stream from the second to the seventh week. In conclusion, T. vitulorum infection elicited mastocytosis and tissue eosinophilia in the duodenum and proximal jejunum, as well as eosinophilia in the blood stream, during the beginning, at the peak and during the rejection of the worm. After the rejection of the worms, the numbers of these cells returned to normal levels suggesting that these cells may have a role in the process of rejection of T. vitulorum by the host. (C) 2003 Elsevier B.V. B.V. All rights reserved.

Calcium gluconate and sodium succinate for therapy of sodium fluoroacetate experimental intoxication in cats: clinical and electrocardiographic evaluation

Sodium fluoroacetate (SFAC) or Compound 1080 is a potent rodenticide, largely used after 1946 for rodent and home pest control. The toxic effects of SFAC are caused by fluorocitrate action, a toxic metabolite, which has a competitive action with aconitase enzyme, leading to citrate accumulation and resulting in interference in energy production by Krebs cycle blockade. In the present study, domestic cats were intoxicated with oral doses of fluoroacetate (0.45 mg/kg). The intoxicated animals presented emesis, diarrhea with abdominal pain posture and an abdominal palpation, tachypnea, bilateral midriasis, hypothermia, hyperexcitability and convulsions. Blood gas analysis indicated decreased pH and bicarbonate levels. Serum ionized calcium was also decreased. ECG showed non-specific changes in ventricular repolarization and ventricular arrhythmias. The survival rate was 75% in the treated group with calcium gluconate and sodium succinate and 37.5% in the non-treated group.

Cytokines released from blood monocytes and expressed in mucocutaneous lesions of patients with paracoccidioidomycosis evaluated before and during trimethoprim-sulfamethoxazole treatment

Background Mucocutaneous lesions in paracoccidioidomycosis are granulomatous and result from tissue responses to Paracoccidioides brasiliensis, the aetiological agent.Objectives and methods In this study we investigate the expression of tumour necrosis factor (TNF)-alpha, interleukin (IL)-10 and transforming growth factor (TGF)-beta 1 by immunohistochemistry in skin and mucosa lesions from patients with the chronic form of paracoccidioidomycosis, evaluated before and at day 20 of trimethoprim-sulfamethoxazole treatment. Cytokine production by peripheral blood monocytes was also studied by enzyme immunoassay.Results Intense immunostaining for TNF-alpha was detected in mononuclear cells that infiltrated granulomas in all skin and mucosa lesions before treatment simultaneously with low IL-10 granular deposits in these cells. At day 20 of treatment, there was reduced TNF-alpha and IL-10 deposition. Immunoreactive TGF-beta 1 was observed diffusely in the dermis and generally in the cytoplasm of macrophages and giant cells, before treatment, and as increased TGF-beta 1 deposits in the fibrosis area at day 20 of treatment. Peripheral blood monocytes from patients with paracoccidioidomycosis, evaluated before treatment, produced high endogenous levels of TNF-alpha, TGF-beta 1 and IL-10 in relation to healthy controls. Lipopolysaccharide-stimulated monocytes from patients secreted lower levels of TNF-alpha in both periods of evaluation while no impairment in capacity of IL-10 and TGF-beta production was observed.Conclusions Trimethoprim-sulfamethoxazole therapy was effective in decreasing fungal load in the lesions, allowing patient immune response to control the infection leading to the healing of the lesions.

Assessment of cytokine values in serum by RT-PCR in HIV-1 infected individuals with and without highly active anti-retroviral therapy (HAART)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Potentially modifiable predictors of mortality in patients treated with long-term oxygen therapy

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)