Associação entre a concentração de selênio, o polimorfismo Pro198Leu da glutationa peroxidase 1 e a mortalidade em pacientes com choque séptico

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Procalcitonina e interleicina-6 em crianças com diagnóstico de sepse e choque séptico

Sepse é causa comum de mortalidade e morbidade em unidades de tratamento intensivo, sendo atualmente entendida como a resposta sistêmica à infecção, resposta esta caracterizada por duas ou mais das seguintes manifestações: temperatura corporal > 38°C ou < 36°C; taquicardia; taquipnéia; e alteração da contagem de células brancas (leucocitose ou leucopenia) ou mais de 10% de formas imaturas. Entretanto, tem sido descrito que os elementos que caracterizam a resposta sistêmica são muito sensíveis, insuficientemente específicos e não levam em consideração o avanço do entendimento da fisiopatologia da doença. Além disso, a sepse tem fisiopatologia complexa, o que dificulta ainda mais o diagnóstico, principalmente em crianças. O diagnóstico rápido e a instituição de tratamento o mais cedo possível são imperativos nos pacientes sépticos. Consequentemente, vários marcadores laboratoriais têm sido estudados, sendo que dos vários mediadores envolvidos na sepse, procalcitonina (PCT) e interleucina-6 (IL-6) têm despertado interesse pela possibilidade de auxiliar no diagnóstico e no estabelecimento da gravidade de pacientes adultos com sepse ou choque séptico, sendo que a PCT já foi incluída entre os critérios diagnósticos de sepse nestes indivíduos. Em pediatria... (Resumo completo, clicar acesso eletrônico abaixo)

Direcionamento de peptídeos tolerogênicos da proteína de choque térmico 60 para células dendríticas utilizando anticorpos anti-DEC-205

A indução de tolerância imunológica em situações altamente desejadas como no transplante e em doenças autoimunes permanece um grande desafio para pesquisa científica de tradução. Nesse contexto, o estudo das proteínas do choque térmico (HSPs) e seus peptídeos vêm trazendo informações relevantes sobre o controle da reposta imune. Dados da literatura mostram que alguns de seus peptídeos apresentam propriedades imunorreguladoras, como os peptídeos N3 e N7 da HSP60. Além disso, tem se mostrado que a apresentação de antígenos em contextos específicos por células dendríticas (DCs) pode favorecer o estabelecimento da tolerância imunológica. Dessa forma, o direcionamento dos peptídeos tolerogênicos da HSP60, N3 e N7, in vivo, para DCs, com o intuito de essas células apresentarem esses peptídeos em um contexto imunorregulador, pode induzir um estado de tolerância. Assim, nesse trabalho, tivemos como objetivo a produção de anticorpos (Acs) contra o receptor DEC-205 de DCs conjugados com os peptídeos N3 e N7 da HSP60. Esses Acs, ao se ligarem ao DEC-205 nas DCs, podem ser fagocitados, processados e por fim apresentados a células T em um contexto imunorregulador. Para tal, foram realizadas transfecções de células HEK-293T e CHO com plasmídeos codificando as cadeias leve e pesada dos respectivos Acs a fim de se obter essas proteínas recombinantes. Podemos observar que as células HEK apresentaram uma produção mais eficiente dos Acs quando comparadas com as células CHO (120 vs 30 ng/ml, respectivamente), apesar disso a produção dos Acs ficou abaixo do esperado impossibilitando a realização ensaios in vivo. Além disso, realizamos um ensaio de ligação do Ac anti-DEC-N7 a superfície de DCs e observamos que os Acs produzidos apresentam capacidade de se ligarem a superfície dessas células. Concluímos que os anticorpos recombinantes anti-DEC-205 são capazes... (Resumo completo, clicar acesso eletrônico abaixo)

Fractografia quantitativa e o conceito de tenacidade à fratura para a análise do efeitodo choque térmicos em TiO2

The present study evaluated the use of semicircular bending test (SCB) as an alternative to conventional bending test to examine the effect of thermal shock. Still, studies the behavior of fracture surfaces generated by monofractal behavior analysis, which allows us to evaluate the contributions of the microstructure and the mechanical context in forming reliefs during the crack propagation. The fractal analysis is made from elevation maps obtained by reconstruction method by extension of the focus stacks of digital images acquired in microscope. The specimens used were samples semicircular pressed TiO2 (rutile) with and without heat shock, prepared for testing mode I loading. Were also produced, specimens in the form of bars for Weibull statistical analysis. From the three-point bending test, we found the variation of fracture toughness between the samples after the heat shock and natural condition. The SCB test was feasible for the analysis of thermal shock resistance. The results showed that the value of the fracture toughness decreases as the heat shock treatment

Ação dos inotrópicos e vasopressores na estabilização hemodinâmica em cães com choque séptico

Septic shock remains one of the most common challenges for the small animal practicing, presenting high mortality rates frequently associated with late identification of this syndrome, as well as an inappropriate treatment. In general, disruption of homeostasis occurs with an intense activation of inflammatory cascade, which leads to a damage to endothelial cells and an exposure to these cytokines, which will result in vasodilation and increased capillary permeability. Thus, there is a drop in blood pressure, even after aggressive fluid resuscitation. Therefore, drugs such as vasopressors, which act by increasing systemic vascular resistance, and inotropes, which have an effect on heart pump, should be administered in order to raise blood pressure, ensuring adequate tissue perfusion. The objective of this review was to gather information about the various drugs used in vasopressors/inotropes therapy, trying to explain the role of each one in different situations, in order to increase the survival rate in dogs affected with septic shock

Choque

The shock, now known as a clinical syndrome due to a systemic breakdown in tissue perfusion leading to cellular hypoxia, metabolic changes and consequently organ dysfunction, is a condition that affects both humans and animals and should be classified as an emergency. For its dynamic course the therapy becomes a challenge, all the time time spared in diagnosis and treatment is essential to save the patient's life, so knowledge of its physiopathology can become of great value, and in order to clarify it better, shock has been divided didactically into: cardiogenic, hypovolemic, distributive, and obstructive, so the best approach may be chosen to this situation, noting that the therapy in general is the sum of several procedures that aims to compensate for the animal so that the underlying cause of shock may be treated

Avaliação das doses de cães submetidos a exames radiográficos de pulmão

This study aims to determine surface skin doses in dogs (with suspected pulmonary metastasis) submitted to chest X-rays using the technique of thermoluminescence dosimetry. Twenty seven exams from different dogs were performed at the Faculdade de Medicina Veterinária e Zootecnia da Universidade Estadual Paulista (FMVZ-UNESP/Botucatu). The doses were evaluated using thermoluminescent dosimeters of calcium sulphate doped with dysprosium (CaSO4:Dy) produced by the Instituto de Pesquisas Energéticas e Nucleares (IPEN-CNEN). The pulmonary metastasis exams are carried out in three projections, one dorsal-ventral and two lateral-lateral. During the procedures the projection thicknesses and source-skin surface distances were registered. To simulate the dog phantom the dosimeters were positioned in a cubic simulator (30x30x30 cm) of polymethylmethacrylate (PMMA) filled with water and irradiated according to the parameters of projections with the X-ray energies ranging from 45 to 70 kV. To estimate the surface skin dose the dose-response curves were obtained for X-ray energies of 50 and 70 kV using the diagnostic X-ray beam machine of the Instruments Calibration Laboratory of IPEN for doses of 1.5, 2.0, 2.5, 3.5 and 4.0 mGy. The main difficulty of this work was the dog immobilization that is reflected in poor-quality diagnostic imaging and, consequently, demands the repetition of the exams, which contributes to the increase of the doses received by the animals being studied and the clinical staff. The doses evaluated in this type of procedure are between 0.43 and 4.22 mGy. This research has shown to be extremely important for the assessment of doses involved in veterinary diagnostic radiology procedures, and as a parameter in the individual monitoring of pet’s owners who assist the animal positioning and occupationally exposed workers of the Department of Veterinary Radiology

Busca de novos alvos terapêuticos no tratamento de câncer de pulmão utilizando ferramentas de biologia de sistemas

A quimioterapia e uma das formas de tratamentos para o câncer, cujo processo e pela aplicação de medicamentos que alteram a síntese de DNA, interrompendo a divisão celular. No caso do câncer de pulmão, a difículdade está no fato de que as células cancerígenas criam quimiorresistência após um determinado período de tempo. Se o indivíduo desenvolver o câncer de pulmão novamente, deverá ser aplicado outro quimioterápico no paciente, e assim por diante. Nos tratamentos atuais são utilizados combinações de drogas para contornar o problema da quimiorresistência. Este trabalho utilizou a biologia de sistemas para encontrar novos alvos protéicos para auxiliar no desenvolvimento de novos quimioterápicos para o tratamento do câncer de pulmão. Foi construída uma rede baseada nos alvos protéicos já conhecidos. A rede foi expandida com o intuito de buscar quais são as proteínas que interagem com os alvos protéicos á conhecidos. Após a expansão, foram utilizadas análises de centralidades para evidenciar as proteínas mais importantes na rede, e correlacionamos com informação de expressão gênica para verificar se as proteínas mais importantes do ponto de vista topológico estão diferencialmente sub ou super expressas. A análise de centralidade junto a mostra dos dados de expressão gênica convergiu para um bom resultado, foi possível evidenciar algumas proteínas que podem ser utilizadas como novos alvos quimioterápicos

MicroRNoma do carcinoma de pulmão de células não pequenas

Pós-graduação em Bases Gerais da Cirurgia - FMB

Carcinoma de células escamosas em assoalho vaginal de um bovino nelore associado a metástase em pulmão: relato de caso

The squamous cell carcinoma (SCC) is a neoplasm that affect pets and production animals and it’s very common in tropical countries like Brazil; develops in sparsely pigmented, stratified squamous epithelium and in mucosal surfaces exposed Ultraviolet action. The SCC is quite infiltrative but rarely causes metastases. Its occurrence in the female reproductive tract is recognized in the literature on cattle breeds from Europe. This case was a female bovine, Nelore, adult, who was referred to the "Hospital Veterinário Luiz Quintiliano de Oliveira" with dark brown fluid leakage and putrid odor, associated with ulcerative growth of the vagina. Because the extent of injury, the animal was euthanized and taken to the necropsy, which was observed on board structure, ulcerated and pus in the vaginal floor, infiltrated into the pelvic cavity to the serosa of the uterine body. The microscopic findings were detected neoplastic proliferation of epithelial cells in the floor and vaginal metastases in the lung parenchyma, and classified the primary tumor and metastasis as squamous cell carcinoma moderately differentiated.

Utilização do choque osmótico na avaliação da viabilidade de sêmen criopreservado de ovinos

This study evaluated the use of hipoosmotic swelling test (HOST) with deionized water (0 mOsmol), as a method of post thaw ram semen evaluation and correlate their findings with different techniques of semen evaluation. Therefore, twenty semen samples of 20 different adult rams were assessed as for kinetic sperm parameters through computerized system (IVOS 12, Hamiton Thorn Biosciences, Beverly, MA, EUA) and subjective analysis. The sperm membranes viability was carried out by the association of fluorescent probes (propidium iodide, JC-1 and FITC-PSA). The structural integrity of the plasma membrane was also studied through supravital test with eosin and the functional integrity of membrane evaluated by doing the hipoosmotic swelling test with deionized water (0 mOsmol), in the following proportions: One part of semen for 10 (HOST 10), 50 (HOST 50) and 100 (HOST 100) parts of water. After semen dilution in the different proportions it was fixed in formalin-buffered saline and analyzed with regard to percentage of HOST reactive sperm (bent/coiled). The percentage of reaction obtained for HOST 10 (33,1%); HOST 50 (32,8%) and HOST 100 (31,8%) did not differ significantly. HOST 10 presented positive correlation with the plasma membrane integrity by the EOS (r = 0,80; p < 0,05). Positive correlations between HOST 50 and HOST 100 with sperm subpopulation with membrane integrity by fluorescence were observed (r = 0,83 and r = 0,85; p < 0,01). The findings suggest that the HOST with deionized water can provide additional information for post thawing ram sperm viability evaluation.

Summary of the II Brazilian Guideline Update on Acute Heart Failure 2009/2011

In the past two years we observed several changes in the diagnostic and therapeutic approach of patients with acute heart failure (acute HF), which led us to the need of performing a summary update of the II Brazilian Guidelines on Acute Heart Failure 2009. In the diagnostic evaluation, the diagnostic flowchart was simplified and the role of clinical assessment and echocardiography was enhanced. In the clinical-hemodynamic evaluation on admission, the hemodynamic echocardiography gained prominence as an aid to define this condition in patients with acute HF in the emergency room. In the prognostic evaluation, the role of biomarkers was better established and the criteria and prognostic value of the cardiorenal syndrome was better defined. The therapeutic approach flowcharts were revised, and are now simpler and more objective. Among the advances in drug therapy, the safety and importance of the maintenance or introduction of beta-blockers in the admission treatment are highlighted. Anticoagulation, according to new evidence, gained a wider range of indications. The presentation hemodynamic models of acute pulmonary edema were well established, with their different therapeutic approaches, as well as new levels of indication and evidence. In the surgical treatment of acute HF, CABG, the approach to mechanical lesions and heart transplantation were reviewed and updated. This update strengthens the II Brazilian Guidelines on Acute Heart Failure to keep it updated and refreshed. All clinical cardiologists who deal with patients with acute HF will find, in the guidelines and its summary, important tools to help them with the clinical practice for better diagnosis and treatment of their patients.

Manifestação rara de edema agudo de pulmão associado à miocardite lúpica aguda

O lupus eritematoso sistêmico (LES) é a mais comum das doenças auto-imunes sistêmicas, ocorrendo com maior freqüência no sexo feminino, usualmente na faixa etária entre 16 e 55 anos1,2. Embora os rins classicamente sejam os órgãos mais acometidos no LES, o coração e a circulação cardiopulmonar também podem ser afetados de forma significativa3. Nesse contexto, a ocorrência de edema agudo de pulmão associado à miocardite lúpica é rara e de tratamento imunossupressor específico ainda incerto.