810 resultados para insuficiência da valva mitral
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Pós-graduação em Fisiopatologia em Clínica Médica - FMB
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Pós-graduação em Cirurgia Veterinária - FCAV
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Pós-graduação em Fisiopatologia em Clínica Médica - FMB
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Biologia Geral e Aplicada - IBB
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Introdução: Pacientes portadores de próteses valvares cardíacas mecânicas devem medicados continuamente com anticoagulantes orais para evitar acidentes tromboembólicos. Estes pacientes são avaliados continuamente para o controle da anticoagulação oral. Objetivo: Comparar a ocorrência de complicações tromboembólicas e hemorrágicas em portadores de próteses valvares cardíacas mecânicas de um (mono) e de dois (bi) folhetos na posição mitral em terapêutica anticoagulante. Métodos: Foram estudados, no intervalo de 10 anos, 117 pacientes portadores de prótese na posição mitral, sendo 48 com próteses de folheto único e 69 de folheto duplo. Avaliou-se a ocorrência de complicações tromboembólicas e hemorrágicas de grau maior e menor de acordo com a gravidade. Os resultados estão apresentados sob forma de estudo atuarial e de frequência linearizada de ocorrência de eventos. Resultados: As curvas atuariais mostraram que, ao longo do tempo, os pacientes portadores de próteses valvares monofolheto estiveram menos livres de complicações tromboembólicas que os pacientes com próteses bifolheto, enquanto que, estes últimos (bifolheto) estiveram menos livres de acidentes hemorrágicos. As frequências linearizadas de ocorrência para tromboembolismo foram maiores nos pacientes com próteses monofolheto. Nos episódios hemorrágicos as taxas foram maiores para os portadores de próteses bifolheto. Conclusão: Os portadores de próteses valvares cardíacas monofolheto mostraram-se mais propensos à ocorrência de acidentes tromboembólicos graves em relação aos com próteses bi folheto. Os pacientes com prótese bifolheto apresentaram maior sangramento que os pacientes com prótese monofolheto, no entanto, esta diferença se restringiu aos sangramentos de pouca gravidade.
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Anemia is a prevalent comorbidity and marker of a poorer prognosis in patients with heart failure (HF). Its clinical relevance, as well as its pathophysiology and the clinical management of these patients are important subjects in the specialized literature. In the present review, we describe the current concepts on the pathophysiology of anemia in HF, its diagnostic criteria, and the recommendations for iron supplementation. Also, we make a critical analysis of the major studies showing evidences on the benefits of this supplementation. The four main components of anemia are addressed: chronic disease, dilutional, renal and malabsorption. In patients with HF, the diagnostic criteria are the same as those used in the general population: serum ferritin levels lower than 30 mcg/L in patients without kidney diseases and lower than 100 mcg/L or serum ferritin levels between 100-299 mcg/L with transferring saturation lower than 20% in patients with chronic kidney diseases. Finally, the therapeutic possibilities for anemia in this specific patient population are discussed.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Chronic Renal Failure (CRF) is the most common disease among dogs of any breed. It is the cause of high levels of morbidity and death rate in dogs. It's important to have an early diagnostic of the dogs condition and immediately start a supportive treatment for CRF. In this research we are discussing the most common types of treatment focused in reducing the progression of this disease and better quality of life for the animal with IRC
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Infective endocarditis is a process in which an infection attacks the heart endothelial surface, and is commonly caused by bacterial colonization, which is called bacterial endocarditis. It is a condition rarely found in dogs and cats, and is more prevalent in male dogs of large size. It mainly affects the left side of the heart, affecting the mitral and aortic valves with greater frequency. The circulation of the bacterium in the bloodstream is what gives rise endocarditis, and is caused by any non-aseptic process that serves as a gateway for bacterium in the body, as from a skin lesion, even as an invasive procedure, such as, catheterization and surgery. The ante-mortem diagnosis is difficult because the clinical signs of endocarditis are varied and common to other diseases, summing up the signs of infection (fever, lethargy, weight loss), and presence of heart murmur and may show signs of congestive heart failure. Thus, the diagnosis is most often through autopsy. To arrive at a diagnosis should be used, besides the history and physical examination, some laboratory tests, especially blood cultures and echocardiography. Treatment is accomplished through the use of antibiotics for long period of time, it is very important to follow the results of susceptibility after its outcome is revealed. The prognosis for bacterial endocarditis ranges from guarded to poor, and can be assessed mainly by the echocardiography. There are few studies in veterinary about the bacterial endocarditis, and the majority is case reports
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Aortic regurgitation (AR) leads to a left ventricle dilation and hypertrophy in response to a chronic volume overload. It is still very frequent in developing countries, for instance Brazil, and often as secondary to rheumatic fever. Usually, chronic AR is generally well tolerated for many years, when with the heart dilated the patient searches for treatment. Bidirectional association with depression and cardiovascular disease has been described. Selective serotonin reuptake inhibitors (SSRI) are widely prescribed to treat several affective disorders, especially for cardiovascular patients since they decrease arrhythmia probability. These SSRI improves cardiac function in rats submitted to stress protocols. Preliminary study from our laboratory showed that following 4 weeks of treatment with one SSRI (paroxetine) in subchronic AR rats there was a decreased in daily sodium intake and an improvement in systolic function. An increase in the central oxytocinergic transmission may be involved in this peripheral improvement to the heart. The investigations about the mechanisms underlying this improvement are necessary. Therefore the aims of this project is investigate the effects of 4 weeks of treatment of paroxetine, a SSRI, in rats with a subchronic AR over the central central gene expression of oxytocin and vasopressin using a reverse transcription polymerase chain reaction (RT-PCR)
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The liver has many biological functions that contribute to the proper functioning of the organism. Liver failure is the loss of these functions, leading to the appearance of complications that worsen the general clinical condition of the patient. This review shows the main complications of liver failure, explaining their pathogenesis and the possible forms of treatment in an attempt to improve the quality of life of patients during treatment of the disease that causes liver failure