Medidas da dinâmica respiratória em idosos participantes de grupos de terceira idade

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

Uso de membrana biossintética a base de celulose na regeneração tecidual guiada

Guided Tissue Regeneration (GTR) is a regenerative treatment modality that requires the placement of a physical barrier over a bone defect in such a way that the proliferation of the surrounding soft tissues into the barrier-protected area is prevented. Thereby in the guided osseous regeneration allowing bone-forming cells from the existent bone edges to invade the space and produce bone. The physical barriers should be biocompatible, allow cellular occlusion, maintain adequate space, tissue integration and facility in the application. They can be occlusive or permeable, absorbable or non-absorbable. Among various types of physical barriers in the market, the cellulose biosynthetic membrane is emphasizing by the necessary characteristics for GTR and to be a national product developed in low cost.

Dexmedetomidine Alters the Cardiovascular Response During Infra-Renal Aortic Cross-Clamping in Sevoflurane-Anesthetized Dogs

Some properties of the volatile anesthetics, such as vasodilatation and myocardial depression, combined with the sympathetic inhibition that alpha 2-agonists can produce may determine hemodynamic alterations during aortic, surgery. The interaction between dexmedetomidine (DEX), an alpha 2-agonist, and sevoflurane during aortic surgery is unknown. We studied the effects of DEX on hemodynamics and systemic oxygenation during aortic cross-clamping (Aox) and unclamping (UAox) in sevoflurane-anesthetized dogs Twenty dogs were. anesthetized with sevoflurane and were randomly assigned to two groups prior to Aox and UAox: control, n = 10, received saline infusion only, and DEX (1 mu g.kg(-1) load followed by 1 mu g.kg(-1).h(-1) infusion), n = 10. Hemodynamic and oxygenation variables were measured at baseline, after saline or DEX loading dose, 20 and 40 min after Aox, and 20 and 40 min after UAox. After DEX administration, heart rate, cardiac index l and systemic oxygen transport index (131021) were lower than in control group. Aox increased mean arterial pressure (MAP) and systemic vascular resistance index (SVRI) in both groups, but the effects were greater with DEX. Cl, heart rate, and DO(2)I were lower, while central venous pressure (CVP) and pulmonary artery occlusion pressure were higher in DEX compared to control. After UAox, MAP, CVP and SVRI were maintained higher in DEX in relation to control. We conclude that in sevoflurane-anesthetized dogs DEX alters the cardiovascular response during aortic surgery.

Enzyme Biomarkers of Renal Tubular Injury in Arterial Surgery Patients

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

Extrinsic compression of popliteal artery in asymptomatic athlete and non-athlete individuals - A comparative study using duplex scan (color duplex sonography)

Aim. Extrinsic compression of the popliteal artery and absence of surrounding anatomical abnormalities characterize the functional popliteal artery entrapment syndrome (PAES). The diagnosis is confirmed to individuals who have typical symptoms of popliteal entrapment and occlusion or important stenosis of the popliteal artery with color duplex sonography (CDS), magnetic resonance imaging (MRI) or arteriography during active plantar flexion-extension maneuvers. However, variable result findings in normal asymptomatic subjects have raised doubts as to the validity of these tests. The purpose of this study was to compare the frequency of popliteal artery compression in 2 groups of asymptomatic subjects, athletes and non-athletes.Methods. Forty-two individuals were studied. Twenty-one subjects were indoor soccer players, and 21 were sedentary individuals. Physical activity was evaluated through questionnaires, anthropometric measurements, and cardiopulmonary exercise test. Evaluation of popliteal artery compression was performed in lower limbs with CDS, ankle-brachial index (ABI) measurements and continuous wave Doppler of the posterior tibial artery.Results. The athletes studied fulfilled the criteria of high level of physical activity whereas sedentary subjects met the criteria of low level of activity. Popliteal artery compression was observed with CDS in 6 (14.2%) studied subjects; 2 of whom (4.7%) were athletes and 4 (9.5%) were non-athletes. This difference was not statistically significant (p=0.21). Doppler of the tibial arteries and ABI measurements gave good specificity and sensibility in the identification of popliteal artery compression.Conclusion. The frequency of popliteal artery compression during maneuvers in normal subjects was 14.2% irrespective of whether or not they performed regular physical activities. Both Doppler and ABI showed good agreement with CDS and should be considered in screening popliteal arteries in individuals suspected of PAES.

Estudo da ação do extrato de Ginkgo biloba e amido hidroxietílico hipertônico na atenuação de alterações decorrentes de isquemia e reperfusão de órgãos esplâncnicos em ratos

A oclusão e reperfusão das artérias esplâncnicas ocasiona choque circulatório, causado principalmente pelo aumento de permeabilidade vascular e pela agressão celular provocada por radicais livres derivados do oxigênio. Este estudo tem por finalidade verificar a ação do extrato de Ginkgo biloba (Egb-761) e do amido hidroxietílico (AHH) na prevenção do choque circulatório produzido pela isquemia e reperfusão de órgãos esplâncnicos. O Egb-761 tem propriedades antioxidantes relatadas na literatura. O AHH, tem sido utilizado como recurso terapêutico do choque hipovolêmico. Ratos anestesiados receberam infusão contínua de Egb-761 ou AHH, sendo submetidos à isquemia (oclusão do tronco celíaco, artéria mesentérica superior e artéria mesentérica inferior por 30 minutos) e reperfusão (por 90 minutos) dos órgãos esplâncnicos. Foram feitas: análise histopatológica ileal, dosagem de malondialdeído ileal e determinação contínua da pressão arterial média (PAM). A PAM ao final do período de reperfusão foi significativamente mais elevada nos animais tratados com Egb-761 e AHH, que no grupo controle (F=18,29; p<0,001). Não houve diferença entre os grupos tratados e controle quanto à dosagem de MDA (H=4,61; p>0,10) e quanto às alterações histológicas (H=6,003; p>0,10). em conclusão, houve melhora nas condições hemodinâmicas, com atenuação do choque nos ratos que receberam Egb-761 ou AHH. Novos estudos serão necessários para se avaliar melhor as alterações histológicas e para esclarecer a formação de produtos finais da peroxidação lipídica.

Effects of pentoxifylline and n-acetylcysteine on injuries caused by ischemia and reperfusion splanchnic organs in rats

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

Glutaraldehyde-treated homologous vein graft as a vein substitute: experimental study in rabbits

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos da ligadura do ducto pancreático e da secção ductal com livre drenagem de secreções para o peritônio sobre as funções endócrina e exócrina do pâncreas: estudo clínico e laboratorial em coelhos

As ressecções pancreáticas seguidas de anastomoses acompanham-se de altas taxas de morbidade, que incluem: surtos de pancreatite e, principalmente, fístulas digestivas. Nos transplantes pancreáticos a drenagem da parte exócrina do enxerto para o intestino ou para a bexiga, além das peculiaridades técnicas, também não é isenta de diversas complicações. Visando evitar ou atenuar tais conseqüências e simplificar a técnica cirúrgica, têm sido usadas outras abordagens para o tratamento ductal do coto/enxerto pancreático, tais como: drenagem livre de secreções para o peritônio, com o ducto pancreático aberto, ligadura ductal e oclusão do ducto com polímeros sintéticos. OBJETIVO: O presente estudo visa avaliar clínica e laboratorialmente as funções endócrina e exócrina do pâncreas de coelhos com o ducto aberto e ligado. MÉTODOS: Foram realizadas 150 operações, divididas em 3 grupos: N - manipulação/controle (n=50), A - grupo aberto (n=50), e L - ligado (n=50). Os momentos de observação foram pré-operatório, dia 0 (dia da operação) e pós-operatório (observação e sacrifício): 7 dias, 14 dias, 28 dias, 90 dias e 180 dias. Os parâmetros analisados foram: estado geral, atividade, controles do peso corporal, ingestão hídrica, ingestão alimentar e dosagens da amilase sangüínea, glicemia, glicose urinária e insulina plasmática. RESULTADOS: Todos os grupos tiveram evolução clínica similar, com bom estado geral, ganho ponderal progressivo e valores normais da ingestão hídrica e ingestão alimentar. Exceto uma significativa elevação da amilase sangüínea nas primeiras 24-48h para os 2 grupos com interferência ductal, não houve qualquer alteração dos níveis basais da glicemia, glicosúria e insulinemia entre os 3 grupos experimentais, em todos os momentos de observação. CONCLUSÃO: À exceção da amilase sangüínea, cujos níveis basais foram significativamente elevados no 1º e 2º dias de pós-operatório, as duas modalidades técnicas de abordagem da secreção exócrina do pâncreas, utilizadas em coelhos, não determinaram quaisquer alterações clínicas, bem como dos níveis basais de glicose sangüínea, glicose urinária e insulina plasmática, durante 6 meses de seguimento.

beta-carotene attenuates the paradoxical effect of tobacco smoke on the mortality of rats after experimental myocardial infarction

The objective of this study was to investigate the effects of exposure to tobacco smoke (ETS) in rats that were or were not supplemented with dietary beta-carotene (BC), on ventricular remodeling and survival after myocardial infarction (MI). Rats (n = 189) were allocated to 4 groups: the control group, n = 45; group BC administered 500 mg/kg diet, n = 49, BC supplemented rats; group ETS, n = 55, rats exposed to tobacco smoke; and group BC+ETS, n = 40. Wistar rats weighing 100 g were administered one of the treatments until they weighed 200 to 250 g (similar to 5 wk). The ETS rats were exposed to cigarette smoke for 30 min 4 times/d, in a chamber connected to a smoking device. After reaching a weight of 200-250 g, rats were subjected to experimental MI (coronary artery occlusion) and mortality rates were determined over the next 105 d. In addition, echocardiographic, isolated heart, morphometrical, and biochemical studies were performed. Mortality data were tested using Kaplan-Meyer curves and other data by 2-way ANOVA. Survival rates were greater in the ETS group (58.2%) than in the control (33.3%) (P = 0.001) and BC+ETS rats (30.0%) (P = 0.007). The groups did not differ in the other comparisons. Left ventricular end-diastolic diameter normalized to body weight was greater and maximal systolic pressures were lower in the ETS groups than in non-ETS groups. Previous exposure to tobacco smoke induced a process of cardiac remodeling after MI. There is a paradoxical protector effect with tobacco smoke exposure, characterized by lower mortality, which is offset by BC supplementation.

Early rather than delayed administration of lisinopril protects the heart after myocardial infarction in rats

Background: ACE inhibitors have shown beneficial results in several studies after myocardial infarction (MI). However, these studies have shown conflicting results about the ideal starting time of the ACE inhibitors administration after MI and the importance of infarct size.Objectives: This study was designed to assess the long-term effects of lisinopril on mortality, cardiac function, and ventricular fibrosis after MI, in rats.Methods: Lisinopril (20 mg/kg/day) was given on day 1 or 21 days after coronary occlusion in small or large infarctions.Results: the mortality rate was reduced by 39% in early treatment and 30% in delayed treatment in comparison to the untreated rats. Early treatment reduced cardiac dysfunction in small MIs; however, delayed treatment did not. No statistical difference was observed among the groups for large MIs. No statistical difference was observed among the groups with large or small MIs on myocardial hydroxyproline concentration.Conclusions: Both early and delayed treatments with lisinopril increased survival. Treatment exerts no marked effects on fibrosis; early treatment has exerted beneficial influences on cardiac function whereas delayed treatment had no consistent effects. The protective effect of lisinopril is detectable only in small (< 40% of LV) MIs.

Tireóide ectópica cervical lateral: Relato de caso e revisão da literatura

Tireóide ectópica é qualquer tecido tireoideano localizado fora de sua topografia habitual, podendo apresentar-se na linha mediana do pescoço ou, mais raramente, na região cervical lateral. Algumas teorias tentam explicar a origem do tecido tireoideano ectópico: 1. falha na descida da glândula; 2. seqüestro de nódulos tireoideanos; 3. presença de tecido tireoideano na cápsula de linfonodos cervicais; 4. formação teratomatosa; 5. Secundário a anomalias branquiais. Na abordagem diagnóstica, diversos exames têm sido utilizados, sendo o diagnóstico definitivo algumas vezes fornecido apenas pelo estudo histopatológico. Apesar das controvérsias em relação às abordagens terapêuticas apresentadas na literatura, é necessário um planejamento rigoroso para evitar iatrogenias. Conclui-se que a presença de tecido tireoideano ectópico deve ser lembrada no diagnóstico diferencial de massas cervicais laterais, e sua origem histológica considerada, sendo na maioria das vezes metástase de um carcinoma tireoideano oculto. Os autores relatam um caso de tecido tireoideano ectópico lateral no pescoço, em paciente do sexo feminino com bócio colóide mergulhante. Foram realizadas considerações importantes sobre dismorfogênese tireoideana, métodos diagnósticos e opções de tratamento, com revisão da literatura das últimas cinco décadas.

THE ROLE of OXIDATIVE STRESS and LIPID PEROXIDATION IN VENTRICULAR REMODELING INDUCED BY TOBACCO SMOKE EXPOSURE AFTER MYOCARDIAL INFARCTION

OBJECTIVE: To evaluate the roles of oxidative stress and lipid peroxidation in the ventricular remodeling that is induced by tobacco smoke exposure after myocardial infarction.METHODS: After induced myocardial infarction, rats were allocated into two groups: C (control, n=25) and ETS (exposed to tobacco smoke, n=24). After 6 months, survivors were submitted to echocardiogram and biochemical analyses.RESULTS: Rats in the ETS group showed higher diastolic (C = 1.52 +/- 0.4 mm(2), ETS = 1.95 +/- 0.4 mm(2); p=0.032) and systolic (C = 1.03 +/- 0.3, ETS = 1.36 +/- 0.4 mm(2)/g; p=0.049) ventricular areas, adjusted for body weight. The fractional area change was smaller in the ETS group (C = 30.3 +/- 10.1 %, ETS = 19.2 +/- 11.1 %; p=0.024) and E/A ratios were higher in ETS animals (C = 2.3 +/- 2.2, ETS = 5.1 +/- 2.5; p=0.037). ETS was also associated with a higher water percentage in the lung (C = 4.8 (4.3-4.8), ETS = 5.5 (5.3-5.6); p=0.013) as well as higher cardiac levels of reduced glutathione (C = 20.7 +/- 7.6 nmol/mg of protein, ETS = 40.7 +/- 12.7 nmol/mg of protein; p=0.037) and oxidized glutathione (C = 0.3 +/- 0.1 nmol/g of protein, ETS = 0.9 +/- 0.3 nmol/g of protein; p=0.008). No differences were observed in lipid hydroperoxide levels (C = 0.4 +/- 0.2 nmol/mg of tissue, ETS = 0.1 +/- 0.1 nmol/mg of tissue; p=0.08).CONCLUSION: In animals exposed to tobacco smoke, oxidative stress is associated with the intensification of ventricular re-remodeling after myocardial infarction.

Early echocardiographic predictors of increased left ventricular end-diastolic pressure three months after myocardial infarction in rats

Background: The objective of this study was to determine the early echocardiographic predictors of elevated left ventricular end-diastolic pressure (LVEDP) after a long follow-up period in the infarcted rat model.Material/Methods: Five days and three months after surgery, sham and infarcted animals were subjected to transthoracic echocardiography. Regression analysis and receiver-operating characteristic (ROC) curve were performed for predicting increased LVEDP 3 months after MI.Results: Among all of the variables, assessed 5 days after myocardial infarction, infarct size (OR: 0.760; CI 95% 0.563-0.900; p=0.005), end-systolic area (ESA) (OR: 0.761; Cl 95% 0.564-0.900; p=0.008), fractional area change (FAC) (OR: 0.771; CI 95% 0.574-0.907; p=0.003), and posterior wall-shortening velocity (PWSV) (OR: 0.703; CI 95% 0.502-0.860; p=0.048) were predictors of increased LVEDP. The LVEDP was 3.6 +/- 1.8 mmHg in the control group and 9.4 +/- 7.8 mmHg among the infarcted animals (p=0.007). Considering the critical value of predictor variables in inducing cardiac dysfunction, the cut-off value was 35% for infarct size, 0.33 cm(2) for ESA, 40% for FAC, and 26 mm/s for PWSV.Conclusions: Infarct size, FAC, ESA, and PWSV, assessed five days after myocardial infarction, can be used to estimate an increased LVEDP three months following the coronary occlusion.

Trombectomia na angioplastia primária em ponte de safena

O emprego da trombectomia na angioplastia primária demonstra bons resultados clínicos e angiográficos imediatos, por meio de redução da embolização distal e do fenômeno do no-reflow e otimização da perfusão miocárdica. Essa técnica, principalmente usada em artérias coronárias, em raras oportunidades é descrita quando empregada em pontes de safena aortocoronarianas. Relatamos o caso de um paciente de 67 anos com infarto agudo do miocárdio relacionado a oclusão de ponte de safena e submetido a trombectomia com bons resultados.