914 resultados para Regional Blood Flow


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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Intermittent hemodialysis (IHD) and continuous renal replacement therapies (CRRT) are used as Acute Kidney Injury (AKI) therapy and have certain advantages and disadvantages. Extended daily dialysis (EDD) has emerged as an alternative to CRRT in the management of hemodynamically unstable AKI patients, mainly in developed countries.Objectives: We hypothesized that EDD is a safe option for AKI treatment and aimed to describe metabolic and fluid control of AKI patients undergoing EDD and identify complications and risk factors associated with death.Study Selection: This is an observational and retrospective study describing introduction of EDD at our institution. A total of 231 hemodynamically unstable AKI patients (noradrenalin dose between 0.3 and 1.0 ucg/kg/min) were assigned to 1367 EDD session. EDD consisted of 6-8 h of HD 6 days a week, with blood flow of 200 ml/min, dialysate flows of 300 ml/min.Data Synthesis: Mean age was 60.6 +/- 15.8 years, 97.4% of patients were in the intensive care unit, and sepsis was the main etiology of AKI (76.2). BUN and creatinine levels stabilized after four sessions at around 38 and 2.4 mg/dl, respectively. Fluid balance decreased progressively and stabilized around zero after five sessions. Weekly delivered Kt/V was 5.94 +/- 0.7. Hypotension and filter clotting occurred in 47.5 and 12.4% of treatment session, respectively. Regarding AKI outcome, 22.5% of patients presented renal function recovery, 5.6% of patients remained on dialysis after 30 days, and 71.9% of patients died. Age and focus abdominal sepsis were identified as risk factors for death. Urine output and negative fluid balance were identified as protective factors.Conclusions: EDD is effective for AKI patients, allowing adequate metabolic and fluid control. Age, focus abdominal sepsis, and lower urine output as well as positive fluid balance after two EDD sessions were associated significantly with death.

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Gastrointestinal problems are common, especially in endurance athletes, and often impair performance or subsequent recovery. Generally, studies suggest that 30-50 % of athletes experience such complaints. Most gastrointestinal symptoms during exercise are mild and of no risk to health, but hemorrhagic gastritis, hematochezia, and ischemic bowel can present serious medical challenges. Three main causes of gastrointestinal symptoms have been identified, and these are either physiological, mechanical, or nutritional in nature. During intense exercise, and especially when hypohydrated, mesenteric blood flow is reduced; this is believed to be one of the main contributors to the development of gastrointestinal symptoms. Reduced splanchnic perfusion could result in compromised gut permeability in athletes. However, although evidence exists that this might occur, this has not yet been definitively linked to the prevalence of gastrointestinal symptoms. Nutritional training and appropriate nutrition choices can reduce the risk of gastrointestinal discomfort during exercise by ensuring rapid gastric emptying and the absorption of water and nutrients, and by maintaining adequate perfusion of the splanchnic vasculature. A number of nutritional manipulations have been proposed to minimize gastrointestinal symptoms, including the use of multiple transportable carbohydrates, and potentially the use of nutrients that stimulate the production of nitric oxide in the intestine and thereby improve splanchnic perfusion. However, at this stage, evidence for beneficial effects of such interventions is lacking, and more research needs to be conducted to obtain a better understanding of the etiology of the problems and to improve the recommendations to athletes.

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Several reconstructive methods of the alveolar ridge have been reported to make possible future rehabilitations with implants. Many of these methods come from studies done in animals, mainly rats. With this clinical practice based on scientific evidence, any experimental procedure that can be undertaken in real life is fundamental. Thus, any research that emulates as closely as possible those techniques used in humans are important. This study describes the modification of the technique for block bone graft fixation (onlay) in rats using the lag screw-type technique, normally used in clinical procedures for grafts in humans. The conclusion was that the execution of the described procedures minimizes interference of blood flow in the area because of the maintenance of the muscle insertion in the buckle aspect of the most anterior region of the mandible, providing better stability to the graft and better contact interface of the graft and receptor bed.

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

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

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

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The control of blood flow during exercise involves different mechanisms, one of which is the activation of the renin-angiotensin system, which contributes to exercise-induced blood flow redistribution. Moreover, although angiotensin II (Ang II) is considered a potent venoconstrictor agonist, little is known about its effects on the venous bed during exercise. Therefore, the present study aimed to assess the Ang II responses in thefemoral vein taken from sedentary and trained rats at rest or subjected to a single bout of exercise immediately before organ bath experiments. Isolated preparations of femoral veins taken from resting-sedentary, exercised-sedentary, resting-trained and exercised-trained animals were studied in an organ bath. In parallel, the mRNA expression of prepro-endothelin-1 (ppET-1), as well as the ETA and ETB receptors, was quantified by real-time PCR in this tissue. The results show that, in the presence of L-NAME, Ang II responses in resting-sedentary animals were higher compared to the other groups. However, this difference disappeared after co-treatment with indomethacin, BQ-123 or BQ-788. Moreover, exercise reduced ppET-1 mRNA expression. These reductions in mRNA expression were more evident in resting-trained animals. In conclusion, either acute or repeated exercise adapts the rat femoral veins, thereby reducing the Ang II responses. This adaptation is masked by the action of locally produced nitric oxide and involves, at least partially, the ETB- mediated release of vasodilator prostanoids. Reductions in endothelin-1 production may also be involved in these exercise-induced modifications of Ang II responses in the femoral vein.

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Doppler ultrasound enables the assessment of blood flow in real time and has been widely used to aid in pregnancy diagnosis and monitoring in dogs and cats. This technique has a diferencial when compared with the B-mode ultrasound, as it allows the evaluation of vascular hemodynamic characteristics, while the two-dimensional ultrasound allows the diagnosis of pregnancy and fetal viability. Thus, the objective of this review is to describe how circulation is characterized in the uterine and fetal arteries in bitches during pregnancy using Doppler ultrasonography.

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An equine, American Troter, female, 5 years of age, was referred to the Diagnostic Imaging Sector at the Veterinary Hospital of the FMVZ, Unesp, Botucatu Campus, with suspected jugular thrombosis. Ultrasonographic findings were heterogeneous tissue at the lumen of the right jugular vein with blockage of its diameter and collateral blood flow formation.

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Portal hypertension (PH) is the pathological increase in portal vein pressure above normal limits. Two variables control the pressure in the portal system: the resistance to blood flow and blood flow volume in the portal system. If one these variables changes, PH may develop. Classification: Pre-hepatic (e. g. compression of the portal vein), intrahepatic (e. g. chronic hepatitis and cirrhosis) or post-hepatic (e. g. right heart failure). The invasive methods (intravenous catheter) were replaced by an indirect method of diagnosis: Doppler Ultrasound. This technique does not measure portal pressure, but indirectly allows the diagnosis of PH. Average speed of portal flow decrease (<10 cm/s) and hepatofugal flow have been reported in cirrhotic dogs with PH. Currently, the focus of the ultrasound is the detection of acquired collateral portal circulation (ACPC), closely correlated with hepatic encephalopathy. The characterization of these vessels is essential to differentiate them from congenital shunts. They are usually multiple vessels, small and tortuous, with turbulent flow, near to the kidneys, and/or a single and larger vessel, draining into the left renal vein (dilated gonadal vein). Gastric, esophageal and mesenteric varices may occur. After identifying the PH, it is important to determine its origin in order to treat the underlying disease. B-Mode Ultrasound and Doppler are the best choices in cases of suspected PH, because they may recognize not just the hypertension, but also its complications and origin.

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Portosystemic shunt, an hepatobiliary anomaly, much common in dogs and less frequent in cats, can be detected by several diagnostic methods. Among them, the one which stands out is ultrasonography due to its numerous advantages: noninvasive, quick, accessible, relatively low cost and provides useful information relating to the other systems, apart from being a highly sensitive method. Portosystemic shunt diagnosis using ultrasonography becomes highly sensitive when associated with B-mode, color Doppler and pulsed Doppler. A bibliographic survey about portosystemic shunt ultrasonographic diagnosis was carried out, and the main ultrasonographic signals were: decreased hepatic size, difficulty in blood vessels visualization, presence of an anomalous vessel, tortuous with turbulent flow and, finally, increased portal blood flow velocity near the shunting vessel