Continuous measurement of cerebral oxygen saturation (rSO 2) for assessment of cardiovascular status during hemorrhagic shock in a swine model

Background: Early trauma care is dependent on subjective assessments and sporadic vital sign assessments. We hypothesized that near-infrared spectroscopy-measured cerebral oxygenation (regional oxygen saturation [rSO 2]) would provide a tool to detect cardiovascular compromise during active hemorrhage. We compared rSO 2 with invasively measured mixed venous oxygen saturation (SvO2), mean arterial pressure (MAP), cardiac output, heart rate, and calculated pulse pressure. Methods: Six propofol-anesthetized instrumented swine were subjected to a fixed-rate hemorrhage until cardiovascular collapse. rSO 2 was monitored with noninvasively measured cerebral oximetry; SvO2 was measured with a fiber optic pulmonary arterial catheter. As an assessment of the time responsiveness of each variable, we recorded minutes from start of the hemorrhage for each variable achieving a 5%, 10%, 15%, and 20% change compared with baseline. Results: Mean time to cardiovascular collapse was 35 minutes ± 11 minutes (54 ± 17% total blood volume). Cerebral rSO 2 began a steady decline at an average MAP of 78 mm Hg ± 17 mm Hg, well above the expected autoregulatory threshold of cerebral blood flow. The 5%, 10%, and 15% decreases in rSO 2 during hemorrhage occurred at a similar times to SvO2, but rSO 2 lagged 6 minutes behind the equivalent percentage decreases in MAP. There was a higher correlation between rSO 2 versus MAP (R =0.72) than SvO2 versus MAP (R =0.55). Conclusions: Near-infrared spectroscopy- measured rSO 2 provided reproducible decreases during hemorrhage that were similar in time course to invasively measured cardiac output and SvO2 but delayed 5 to 9 minutes compared with MAP and pulse pressure. rSO 2 may provide an earlier warning of worsening hemorrhagic shock for prompt interventions in patients with trauma when continuous arterial BP measurements are unavailable. © 2012 Lippincott Williams & Wilkins.

Cross-talk with β2-adrenoceptors enhances ligand affinity properties from endothelial alpha1D-adrenoceptors that mediates carotid relaxation

Objectives Our main objectives were to investigate the affinity properties of endothelial and muscular α1D-adrenoceptors and to characterize the cross-talk between endothelial α1D- adrenoceptors and β2-adrenoceptors in rat carotid. Methods Relaxation and contraction concentration-response curves for phenylephrine (α1-adrenergic agonist) were obtained in carotid rings in absence or presence of increasing concentrations of BMY7378 (α 1D-adrenergic antagonist), combined or not with increasing concentration of ICI-118,551 (β2-adrenergic antagonist). Schild analysis was used to estimate the affinity constant from pA2 values of BMY7378. Key Findings BMY7378 produced an unsurmountable antagonism on phenylephrine-induced relaxation but a surmountable antagonism on phenylephrine-induced contraction. BMY7378 potency was higher in inhibiting the relaxation than the contraction induced by phenylephrine because the rightward shifts induced by BMY7378 were greater in the relaxation. The apparent pA 2 value for BMY7378 in phenylephrine-induced relaxation was greater than in contraction. When combined with ICI-118,551, BMY7378 yielded a surmountable antagonism on phenylephrine-induced relaxation and presented a pA2 value similar to that obtained in phenylephrine-induced contraction. Conclusions Endothelial α1D-adrenoceptors, which mediates rat carotid relaxation, present high ligand affinity because of the cross-talk with β2-adrenoceptors, which explains the higher potency of phenylephrine in inducing relaxation than contraction and the atypical unsurmountable antagonism produced by BMY7378 on phenylephrine-induced relaxation. © 2013 Royal Pharmaceutical Society.

Horizontal ridge augmentation of the atrophic anterior maxilla using rhBMP-2/ACS or autogenous bone grafts: A proof-of-concept randomized clinical trial

Aim To compare the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge carrier (ACS) with autogenous bone graft for augmentation of the edentulous atrophic anterior maxilla. Methods Twenty-four subjects were enrolled in a randomized, controlled, parallel-group, open-label clinical trial. Subjects either received rhBMP-2/ACS (1.5 mg/ml) or particulated autogenous bone harvested from the mandibular retromolar region. A titanium-mesh was used to provide space and wound stability. A guide was used to standardize clinical recordings using an analogue caliper. Alveolar ridge width was also assessed using cone-beam computed tomography. Results rhBMP-2/ACS yielded significantly greater radiographic horizontal bone gain compared with autogenous bone graft at immediate subcrestal levels (1.5 ± 0.7 versus 0.5 ± 0.9 mm; p = 0.01); non-significant differences were observed at mid- (2.9 ± 0.8 versus 2.9 ± 0.9 mm; p = 0.98) and apical (1.7 ± 0.9 versus 1.8 ± 1.1 mm; p = 0.85) crestal levels. No significant differences in clinical horizontal bone gain were observed at 6 months between rhBMP-2/ACS and autogenous bone graft (3.2 ± 0.9 mm versus 3.7 ± 1.4 mm; p = 0.31). Sixty-two implants were placed after 6 month of healing with no significant differences between groups for number of implants, implant size, primary stability and survival. Conclusions rhBMP-2/ACS appears a realistic alternative for augmentation of the edentulous atrophic anterior maxilla. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

'Ti''O IND.2'/'Sn''O IND. 2 modificado com 'Ag IND. 2''O', para obtenção de fotocatalisadores

Pós-graduação em Química - IQ

Latin American development and the international economic situation: second regional appraisal of the International Development Strategy: volume 1: Economic and social development of Latin America

Incluye Bibliografía

Desarrollo latinoamericano y la coyuntura económica internacional: segunda evaluación regional de la Estrategia Internacional de Desarrollo: volumen 1: Desarrollo económico y social de América Latina

Incluye Bibliografía

Informe de la Reunión Técnica Latinoamericana sobre la Tercera Edad (San José, Costa Rica, 2 al 5 de diciembre de 1980)

Incluye Bibliografía

Report of the Technical Meeting on the Elderly: Latin America (San José, Costa Rica, 2 to 5 December 1980)

Includes bibliography

Óxido nítrico, GSTP-1 e P53: qual o papel desses biomarcadores e suas correlações com as afecções prostática no cão?

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

Avaliação do potencial tripanocida de diaminas, diaminas de ferroceno e derivados de 1,4-naftoquinonas em cepas de Trypanosoma brucei

Pós-graduação em Biotecnologia - IQ

Complexos contendo o ligante 2 - Mercaptopiridina derivados da série '[RUCL IND. 3(NO)(P-P)]'

Pós-graduação em Química - IQ

Resposta de anticorpos IgG contra a região C-terminal da Proteína 1 da Superfície de Merozóitos de Plasmodium vivax em indivíduos que residem em áreas de transmissão de malária no Estado do Pará

Neste estudo avaliamos o potencial antigênico da proteína recombinante His₆-P1₁₉ contendo a região C-terminal da Proteína 1 da Superfície de Merozoítos de Plasmodium vivax. Analisamos a aquisição e os níveis de anticorpos IgG, e comparamos duas áreas com transmissão de malária, localizadas nos municípios de Trairão e Itaituba, Pará. Foram analisadas 391 amostras, sendo 208 amostras coletadas em Três Boeiras (TB) e 183 em São Luiz do Tapajós (SLT). No momento da coleta, foi realizado o exame da gota espessa e foram obtidos dados como idade, número de episódios prévios de malária e tempo decorrido desde o último episódio. As amostras foram analisadas por (ELISA) e os aspectos imunoepidemiológicos foram descritos. A comparação entre as duas áreas mostrou que tanto a freqüência de soros que reconheceram a His₆-MSP1₁₉ como a concentração dos anticorpos IgG foi maior na população de TB, quando comparado com SLT. A freqüência de soros positivos foi 64,42% e 20,22% e a média dos índices de reatividade foi 6,11 ± 4,58 e 2,56 ± 1,96, respectivamente. A idade não influenciou a aquisição de anticorpos IgG na população mais expostas (TB), mas na população menos exposta (SLT) a percentagem de positivos aumentou entre os adultos. Nos grupos de indivíduos que relataram nunca terem tido malária, a freqüência de positivos foi semelhante nas duas localidades. No grupo que relatou ter tido malária, a percentagem de positivos foi maior em TB. Nesses dois grupos, a concentração de anticorpos IgG foi maior na população de TB. Nas duas áreas, o número de episódio influenciou a resposta de anticorpos específicos, sendo que em TB contribuiu para o aumento da percentagem de positivos e da concentração de anticorpos, mas em SLT influenciou apenas na percentagem de positivos. Entretanto, nas duas áreas, não foi possível associar a resposta de anticorpo com proteção, uma vez que os mais expostos estavam tendo malária recentemente. As áreas de estudo apresentaram perfil diferente quanto à intensidade da transmissão de malária e a aquisição natural de anticorpos. Os aspectos imunoepidemiológicos mostraram que a exposição contínua ao parasito contribuiu para a aquisição de anticorpos IgG específicos contra antígeno da fase sangüínea de P. vivax. No entanto, esta resposta não foi efetiva para conferir proteção.