Músculo esquelético, insuficiência cardíaca crônica e o papel do exercício

Patients with chronic heart failure (CHF) show metabolic, hemodynamic and skeletal muscle alterations, which decrease the life expectancy. These alterations are attributed to several factors. The focus of this review was to approach the questions related to physiological, metabolic, morphological and molecular alterations which affect the muscular system of these patients. Later, it was discussed the benefits of physical exercise to this syndrome as well as the pharmacological interventions, which are in investigation aiming the treatment of the same. Some muscle alterations are already described on the literature. For example, the more predominance of type II fibers, lower oxidative enzymatic activity, muscle atrophy and elevated concentration of cytokines that affect the muscle integrity. Thus, further studies involving cellular and molecular mechanisms of skeletal muscle in order to create strategies for prevention and treatment for patients with CHF are required

Efeitos do pentobarbital sódico e do enfluorano sobre a circulação sanguínea hepática: fluxometria eletromagnética e manometria (estudo experimental no cão)

In 18 dogs, previously anesthetized with sodium pentobarbital for the surgical preparation, catheterism and monitoring, the action of sodium pentobarbital (7.5 mg/kg) and enflurane (1.5 - 2%) in the liver circulation was studied. Measurements of the following parameters were made in four different times, before and 15, 30 and 60 min after the drug administration. By direct determination: hepatic artery flow, portal vein flow, mean pressure of the abdominal aorta, peripheral arterial pressure (mean), pressure in the caudal cava vein, portal pressure; and by indirect determination: total flow, arterial-cava gradient, portal-cava gradient, resistance in the hepatic artery territory, resistance in the territory of the portal vein, and total resistance. Based on the results, it is concluded that in the experiment's conditions: sodium pentobarbital doesn't change significantly the hepatic circulation, and enflurance produces a fall in the total hepatic flow, by reducing the portal flow, without alterations of the hepatic arterial flow. It diminishes the total hepatic resistance by diminishing the arterial resistance without alterations of the portal resistance; it diminishes the arterial-cava gradient in consequence of the reduction of the abdominal aorta pressure and of the portal pressure, but it seems that the caudal cava pressure is not altered. It also occurs a fall in the peripheral mean pressure.

Alterações imunitárias na cirrose hepática alcoólica+.

The alcoholic liver cirrhosis usually causes overall immunological changes which might be attributed to either the hepatic disease itself, to ethanol action and/or to malnourishment of the patient. These immune abnormalities comprise both cellular and humoral immunity, consisting of increased immunoglobulin levels, depressed late-skin response to antigens, lowered proliferative response of lymphocytes to mitogens, lower plasma levels of complement proteins (C3 and C4) and by either lower (IL2 and gamma IF) or increased (IL1, TNF, IL6 and IL8) cytokine levels. Parallel to the systemic immune suppression found in most patients, there is also a concomitant local, genetically based, immune stimulation at the liver level which leads to hepatic self-aggression. The systemic immune-suppression could be responsible for periodical infections or neoplasia found in these patients. The possible factors for the immune exhaustion are: a) lower hepatic clearance of toxins and/or bacteria; b) lower hepatic synthesis of complement components; c) cytokines (IL2 and gamma IF) deficiencies, and d) deficiencies of nutrients related to the antioxidant and/or immune defense mechanisms. The immune stimulation of the liver self aggression is characterized by the preferential migration of cytotoxic T cell and neutrophils to the liver, following stimulatory factors such as Mallory bodies, acetaldehyde and/or antibodies. Moreover, the local increase of cytokines (IL1, TNF, IL6 and IL8) levels would be liable for the local phagocyte chemotaxy (IL8) or part of liver injury (TNF) eased by the lower antioxidant defense of the cirrhotic liver.(ABSTRACT TRUNCATED AT 250 WORDS)

Insuficiência renal aguda. Estudo do quadro clínico e prognóstico.

Acute renal failure (ARF) is a frequent complication in hospitalized patients, and is strongly related to increase of mortality. PURPOSE: To analyze the clinical outcome and the prognostic factors in hospital acquired AFR. METHOD: A prospective study was performed. Data from 200 patients with established ARF admitted during the period of January, 1987 and July, 1990 were collected. RESULTS: The incidence of ARF was 4.9/1000 admissions. Renal ischemia (50%) and nephrotoxic drugs (21%) were the main etiologic factors. The histologic study done in 43 patients showed: acute tubular necrosis (53%), tubular hydrophic degeneration (16%), glomerulopathies (16%) and other lesions (15%). Dialysis therapy was performed in 101 patients and the main indications were: uremia (67%), hypervolemia (22%) and hyperkalemia (9%). The mortality rate was 46.5% and the most important causes of death were: sepsis (38%), respiratory failure (19%) and multiple organs failure (11%). Treatment withdraw was the cause of death in 2 patients. Higher mortality was observed in oliguric patients (62.9%) than non-oliguric (34.5%) (p < 0.05) and in ischemic renal failure (56.7%) when compared to nephrotoxic renal failure (14.7%) (p < 0.05). This difference was maintained when the comparison was done only between dialyzed patients. CONCLUSION: As primary cause of death was not associated to the acute renal failure, we conclude that acute renal failure is an important marker of the gravity of the underlying disease and not the cause of death.

Mortalidade e prognóstico específico em pacientes com insuficiência renal aguda

A variety of systems of risk factor stratification have been studied to predict the outcome in acute renal failure (ARF). OBJECTIVES. Assess and compare mortality and the Acute Tubular Necrosis Individual Severity Score (ATN-ISS) in patients with AFR treated in a university hospital. METHODS. A prospective analysis was made of 103 patients with a diagnosis of intrinsic ARF admitted to the Hospital das Clinicas da Faculdade de Medicina de Botucatu, UNESP. Patients were followed up until recovery of renal function or death. The Score ATN-ISS was recorded during the first hours of the assessment by a nephrologist. Results were reported as median or mean ± SD, with statistical significance of p<0.05. RESULTS. Fifty-one percent of patients were male with a mean age of 58 ± 36 years. Forty-four percent died in the hospital. Mortality was higher in patients from the surgical wards (52.7%) and in patients who were treated with dialysis (63.8%). The score ATN-ISS showed a good confidence level, with high discriminatory power (area under the curve of 0.95) and good accuracy. CONCLUSIONS. Mortality in this study was comparable to that found in literature. The ATN-ISS was shown to be a prognostic index with a high confidence level that could be routinely applied by nephrologists to patients with AFR.

Mecanismo de centralização: Da insuficiência placentária à adaptação circulatória fetal

The application and development of obstetric Dopplervelocimetry provide a basis for the investigation of placental insuf ciency and demonstrate the dynamic behavior of fetal circulation during hypoxia. In clinical practice, assessing hemodynamics in three vascular regions involved in pregnancy, namely the uterine, umbilical and middle cerebral arteries, has become routine. Roughly, the cerebral artery expresses the balance between uterine artery oxygen supply and umbilical artery oxygen uptake. Currently, when such balance is unfavorable, the fetal cardiac reserve is investigated by assessing the venous duct. However, determining and interpreting vascular resistance indexes is not an easy task. The starting point is to know the physiopathology of placental insuf ciency and fetal circulatory adaptation through which Doppler con rmed its role in the assessment of fetal well-being.

Parâmetros bioquímicos de avaliação da função renal e hepática de equinos com cólica submetidos a laparotomia, sobreviventes ou não

We examined 46 adult horses - six healthy, as control, (group 1) and 40 horses with colic submitted to treatment by laparotomy. Twenty animals had no postoperative complication (group 2), and twenty died or were euthanized from seven to ten days after the surgery (group 3). There was an increase in serum urea and creatinine concentration and AST, FA and GGT activity of animals from group 1 and group 2, indicative of renal and hepatic injury. The changes were associated with dehydration and endotoxins. Depending on the severity of the colic, animals may develop kidney and liver failure.

Efeito de um protocolo de treinamento concorrente sobre fatores de risco para o acúmulo de gordura hepática de adolescentes obesos

Study Design: Prospective study Objective: To evaluate the effect of a protocol of concurrent training lasting 16 weeks on risk factors for the accumulation of hepatic fat in obese youth. Methods: 38 obese children and adolescents of both sexes, between 12 and 15 years old. The obesity was attested by the percentage of body fat, which was estimated by dual-energy X-ray absorptiometry (DEXA). Additionally, the amount of fat located in the trunk (kg) was estimated too. Before and after the intervention, the youths underwent biochemical blood tests (fasting complete lipid profile [mg / dL]) and ultrasonography of the liver (right size Wolves [LD cm] and left [LE in cm]). The intervention consisted of concurrent training (strength training [30 minutes] and endurance training [30 minutes]) with three sessions per week, totaling 180 minutes a week, for ten weeks. Statistical analysis was made by the test t of Student for paired data using SPSS software (17.0) and significance statistical fixed at p <5%. Results: After the intervention, significant improvements were observed in the percentage of total fat (PRE: 45.1 ± 5.3 and POST: 41.7 ± 5.6, p = 0.001) and in the trunk region (PRE: 46, 5 ± 5.6 and POST: 42.9 ± 6.3, p = 0.001). For lipid profile, reduction in total cholesterol (PRE: 164 ± 34 and POST: 148 ± 29, p = 0.001), triglycerides (PRE: 118 ± 59 and POST: 104 ± 53, p = 0.002) and lipoproteins density (PRE: 100 ± 29 and POST: 85 ± 26, p = 0.001), but not for high-density (p = 0.981). Both the LE (PRE: 8.8 ± 1.4 and POST: 7.8 ± 1.3, p = 0.001) and LD (PRE: 13.6 ± 1.3 and POST: 12.9 ± 1, 1, p = 0.001) experienced a decrease in its proportions. Conclusion: The concurrent training was effective in combating some risk factors to the accumulation of fat in the liver, as well as in reducing fat in both lobes of the organ in young obese.

Fator Pró-digestão inicial® e Isoterápico® na larvicultura da tilápia-do-Nilo: avaliação do índice de parasitismo, integridade hepática e branquial

Pós-graduação em Aquicultura - FCAV

Treinamento aeróbio na prevenção da doença hepática não alcoólica decorrente da obesidade em ratos

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

Avaliação bioquímica, morfológica e funcional do músculo estriado esquelético de ratos na insuficiência cardíaca

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos de ultradiluições de drogas carcinogênicas iniciadoras e da dexametasona na carcinogênese hepática de ratos

Pós-graduação em Ciências Biológicas (Biologia Celular e Molecular) - IBRC

Insuficiência aórtica subcrônica e vias centrais relacionadas à regulação da ingestão de sódio

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)