Trimetazidina e resposta inflamatória em cirurgia de revascularização do miocárdio

FUNDAMENTO: A resposta inflamatória orgânica constitui um mecanismo fisiopatológico presente em todas as cirurgias de revascularização do miocárdio com circulação extracorpórea (CRVM-CEC), e a liberação de mediadores inflamatórios constitui um de seus mecanismos de defesa. OBJETIVO: Avaliar, em estudo prospectivo duplo-cego randomizado e controlado com placebo, os efeitos da trimetazidina (Tmz) sobre a resposta inflamatória, por meio da variação nas interleucinas 6 e 8; TNF-α; complementos C3 e C5, e na proteína C reativa ultrassensível (PCR-us), em dois momentos, pré e pós-operatório. MÉTODOS: Foram estudados 30 pacientes submetidos a CRVM-CEC utilizando cardioplegia hipotérmica intermitente, e com no máximo disfunção ventricular leve, divididos em dois grupos (placebo e Tmz), estratificados por ecocardiografia e recebendo medicação/placebo na dose de 60mg/dia. As amostras foram dosadas no pré-operatório sem medicação, no dia da cirurgia com 12 a 15 dias de medicação/placebo e, seguidamente, 5 min após o desclampeamento aórtico, 12 e 24h, para interleucinas e complementos, e 48h para PCR. RESULTADOS: Não ocorreram diferenças significativas entre os níveis de interleucina 8, Tnf-α, complementos C3 e C5, e PCR-us. No entanto, no grupo tratado, os níveis de interleucina 6 foram significativamente inferiores aos do grupo controle, em todos os momentos analisados. CONCLUSÃO: A trimetazidina mostrou-se eficaz apenas na redução da interleucina 6 nos pacientes submetidos à CRVM.

Aufnahme von Flüchtlingen und Vertriebenen sowie Aspekte und Bestrebungen ihrer Eingliederung/Integration im Kreis Salzwedel 1945 bis 1948/49

Flight and displacement, Research about displaced people, Displaced people in Saxony- Anhalt and in the district of Salzwedel, Arrival and reception, Integration into social life, Administrative activities, Housing, Integration into the labour market, Social welfare activities

Clinical Coronary In-Stent Restenosis Follow-Up after Treatment and Analyses of Clinical Outcomes

Background: Clinical in-stent restenosis (CISR) is the main limitation of coronary angioplasty with stent implantation. Objective: Describe the clinical and angiographic characteristics of CISR and the outcomes over a minimum follow-up of 12 months after its diagnosis and treatment. Methods: We analyzed in 110 consecutive patients with CISR the clinical presentation, angiographic characteristics, treatment and combined primary outcomes (cardiovascular death, nonfatal acute myocardial infarction [AMI]) and combined secondary (unstable angina with hospitalization, target vessel revascularization and target lesion revascularization) during a minimal follow-up of one year. Results: Mean age was 61 ± 11 years (68.2% males). Clinical presentations included acute coronary syndrome (ACS) in 62.7% and proliferative ISR in 34.5%. CISR was treated with implantation of drug-eluting stents (DES) in 36.4%, Bare Metal Stent (BMS) in 23.6%, myocardial revascularization surgery in 18.2%, balloon angioplasty in 15.5% and clinical treatment in 6.4%. During a median follow-up of 19.7 months, the primary outcome occurred in 18 patients, including 6 (5.5%) deaths and 13 (11.8%) AMI events. Twenty-four patients presented a secondary outcome. Predictors of the primary outcome were CISR with DES (HR = 4.36 [1.44–12.85]; p = 0.009) and clinical treatment for CISR (HR = 10.66 [2.53–44.87]; p = 0.001). Treatment of CISR with BMS (HR = 4.08 [1.75–9.48]; p = 0.001) and clinical therapy (HR = 6.29 [1.35–29.38]; p = 0.019) emerged as predictors of a secondary outcome. Conclusion: Patients with CISR present in most cases with ACS and with a high frequency of adverse events during a medium-term follow-up.

Left Atrial Function in Patients with Chronic Chagasic Cardiomyopathy

Background:Chagas disease is a cause of dilated cardiomyopathy, and information about left atrial (LA) function in this disease still lacks.Objective:To assess the different LA functions (reservoir, conduit and pump functions) and their correlation with the echocardiographic parameters of left ventricular (LV) systolic and diastolic functions.Methods:10 control subjects (CG), and patients with Chagas disease as follows: 26 with the indeterminate form (GI); 30 with ECG alterations (GII); and 19 with LV dysfunction (GIII). All patients underwent M-mode and two-dimensional echocardiography, pulsed-wave Doppler and tissue Doppler imaging.Results:Reservoir function (Total Emptying Fraction: TEF): (p <0.0001), lower in GIII as compared to CG (p = 0.003), GI (p <0.001) and GII (p <0.001). Conduit function (Passive Emptying Fraction: PEF): (p = 0.004), lower in GIII (GIII and CG, p = 0.06; GI and GII, p = 0.06; and GII and GIII, p = 0.07). Pump function (Active Emptying Fraction: AEF): (p = 0.0001), lower in GIII as compared to CG (p = 0.05), GI (p<0.0001) and GII (p = 0.002). There was a negative correlation of E/e’average with the reservoir and pump functions (TEF and AEF), and a positive correlation of e’average with s’ wave (both septal and lateral walls) and the reservoir, conduit and pump LA functions.Conclusion:An impairment of LA functions in Chagas cardiomyopathy was observed.

Diastolic Function in Paced Children with Cardiac Defects: Septum vs Apex

AbstractIn children with structural congenital heart disease (CHD), the effects of chronic ventricular pacing on diastolic function are not well known. On the other hand, the beneficial effect of septal pacing over apical pacing is still controversial.The aim of this study was to evaluate the influence of different right ventricular (RV) pacing site on left ventricular (LV) diastolic function in children with cardiac defects.Twenty-nine pediatric patients with complete atrioventricular block (CAVB) and CHD undergoing permanent pacing were prospectively studied. Pacing sites were RV apex (n = 16) and RV septum (n = 13). Echocardiographic assessment was performed before pacemaker implantation and after it, during a mean follow‑up of 4.9 years.Compared to RV septum, transmitral E-wave was significantly affected in RV apical pacing (95.38 ± 9.19 vs 83 ± 18.75, p = 0.038). Likewise, parameters at the lateral annular tissue Doppler imaging (TDI) were significantly affected in children paced at the RV apex. The E´ wave correlated inversely with TDI lateral myocardial performance index (Tei index) (R2= 0.9849, p ≤ 0.001). RV apex pacing (Odds ratio, 0.648; confidence interval, 0.067-0.652; p = 0.003) and TDI lateral Tei index (Odds ratio, 31.21; confidence interval, 54.6-177.4; p = 0.025) predicted significantly decreased LV diastolic function.Of the two sites studied, RV septum prevents pacing-induced reduction of LV diastolic function.

Neuronale Grundlagen der visuomotorischen Verarbeitung bei Normalprobanden und bei Albinismus

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2011

Kritische Betrachtung des Burnout-Syndroms

Fragestellung: Diese Arbeit befasst sich mit der kritischen Auseinandersetzung mit demBurnout-Syndrom, sowie der Stellung dessen in der Öffentlichkeit und den Medien. Im diesemZusammenhang wird der Frage nach der Notwendigkeit dieser Diagnose nachgegangen.Methode: Während einer ausführlichen Literatur- Recherche, in der Stendaler Hochschulbibliotheksowie einer Online-Recherche, wurden viele aktuelle Beiträge zum Thema gesammelt.Auf dieser Grundlage erfolgte die theoretische und kritische Auseinandersetzung mitdem Burnout-Syndrom.Ergebnisse: Bei der Auseinandersetzung mit dem Thema Burnout fällt auf, dass in den letzten40 Jahren seit der „Entdeckung“ lediglich zusätzliche Informationen hinzugefügt werdenkonnten. Jedoch wurden keine validen Daten erhoben und so ist die wissenschaftliche Abgrenzungvon Burnout als eigenständiger Diagnose nicht erfolgt.Diskussion: Positive Effekte, die sich durch die Diagnose ergeben haben, sind Burnoutunspezifischund führen daher zu dem Schluss, dass Burnout als eigenständige klinischeDiagnose unbrauchbar ist.Schlüsselwörter: Burnout – Kritik – Depression - Medien

Vergleichende Expressionsanalysen von stationären und migrierenden Epithelzellen nach in vitro-Verwundung

Magdeburg, Univ., Fak. für Naturwiss, Diss., 2013

Motive, Informationsquellen und Determinanten der Wahl des Studienorts : Befunde aus einer Befragung von Neuimmatrikulierten an der Otto-von-Guericke-Universität Magdeburg im WS 2011/12

Barbara Dippelhofer-Stiem ; Till Krenz. Otto-von-Guericke-Universität Magdeburg, Fakultät für Geistes-, Sozial- und Erziehungswissenschaften, Institut für Soziologie

Erzieherinnen im Vorschulbereich : soziale Bedeutung, berufliche Sozialisation und Professionalität im Spiegel sozialwissenschaftlicher Forschung

Barbara Dippelhofer-Stiem. Otto-von-Guericke-Universität Magdeburg, Fakultät für Geistes-, Sozial- und Erziehungswissenschaften, Institut für Soziologie

Bevölkerung Sachsen-Anhalts im Portrait : sekundäranalytische Auswertungen amtsstatistischer Daten

Barbara Dippelhofer-Stiem. Otto-von-Guericke-Universität Magdeburg, Fakultät für Geistes-, Sozial- und Erziehungswissenschaften, Institut für Soziologie

Wie gesund sind die Menschen in Sachsen-Anhalt? : Befunde des repräsentativen Bevölkerungssurveys "Gesundheit und Wohlbefinden 2003" im Überblick

Barbara Dippelhofer-Stiem. Otto-von-Guericke-Universität Magdeburg, Fakultät für Geistes-, Sozial- und Erziehungswissenschaften, Institut für Soziologie

effect of the extracellular environment on the composition and function of synapses

Otto-von-Guericke-Universität magdeburg, Fakultät für Naturwissenschaften, Dissertation, 2015

Descrição da fêmea de Argyrothemis argentea (Odonata, Libellulidae)

The female of Argyrothemis argentea Ris, 1911 is described and illustrated for the first time. New records expand the distribution range of the species to Central West Region of Brazil.