RESUMEN
Descreve-se um surto de distrofia muscular nutricional em ovinos no semi-árido Nordestino. Foram afetados animais de 3-4 meses de idade, da raça Dorper, pesando 30-40 kg. Os animais eram alimentados, à vontade, com leite, ração balanceada, capim Tifton e sal mineral. Dos 70 animais Dorper, 6 adoeceram e morreram em um período de 48 horas. Apresentaram temperatura, entre 40 e 41ºC, incoordenação com posterior paralisia e decúbito, depressão, prostração e diminuição dos reflexos pupilar e de ameaça, flacidez da língua e mandíbula, salivação, edema submandibular, dispnéia e aumento da freqüência cardíaca. A morte ocorreu após curso clínico de 6- 12 horas. Na necropsia de 3 animais, os músculos esqueléticos estavam de coloração pálida, o fígado estava aumentado de volume e de coloração amarelada, os gânglios parotídeos, submandibulares, retrofaríngeos, prescapulares e mediastínicos estavam aumentados de volume e avermelhados e os pulmões apresentavam áreas vermelhas. Na histologia havia necrose segmentar de todos os músculos examinados e congestão dos gânglios linfáticos e pulmão. Posteriormente mais três animais adoeceram, sendo tratado com oxitetraciclina e complexo vitamínico A,D e E. Desses 3 animais, 2 morreram e um sobreviveu. Na mesma fazenda havia e não adoeceram 20 ovinos da raça Santa Inês, da mesma idade que os animais afetados, que recebiam a mesma alimentação exceto o leite, e 900 ovinos de outras idades. A superalimentação em animais com rápido crescimento e o estresse causado pela restrição de água durantes 2 dias, para aumentar o consumo de leite, parecem ter sido fatores predisponentes para a ocorrência da doença. É possível, também, que algum dos minerais suplementados tenha antagonizado o Se presente na alimentação.
Asunto(s)
Distrofia Muscular Animal/epidemiología , Enfermedad del Músculo Blanco/epidemiología , Enfermedad del Músculo Blanco/fisiopatología , Ovinos/anatomía & histologíaRESUMEN
PURPOSE: This study aimed to verify the effects of paired hemodiafiltration on-line (PHF-AF) on inflammation in patients who were "high responders" to inflammatory stimuli: elevated C-reactive protein (CRP), genetic polymorphisms influencing a low transcription for interleukin-10 (IL-10) and a high transcription for IFN-gamma. METHODS: Ten patients selected as high responders for IFN-gamma and low responders for IL-10 were included in a crossover study to compare PHF-AF and standard bicarbonate hemodialysis (BHD). At study entry and before the start of each dialysis session the following examinations were performed: CRP, albumin, fibrinogen, ferritin, transferrin, prealbumin and serum levels of IL-6, IL-10, IFN-gamma, tumor necrosis factor-alpha (TNF-alpha). After the 1st and 3rd week of the study, the blood samples were also collected after the dialysis session. RESULTS: . There was a significant reduction in albumin and prealbumin in PHF-AF patients during the study; none of the other parameters were changed in both patient groups. CRP tended to be elevated after dialysis in both PHF-AF and BHD. While IL-6, IL-10 and IFN-gamma were unchanged during the dialysis session, there was a significant variation in TNF-alpha levels, which were increased in BHD (from 10.9 +/- 3.1 to 14.7 +/- 4.1 pg/mL; p=0.004) and reduced in PHF-AF (from 11.9 +/-2.8 to 6.3 +/- 2.2 pg/mL; p=0.0004). CONCLUSION: Although the cytokine levels were unchanged during the study in both BHD and PHF-AF, the modification of TNF-alpha during the dialysis session was considered as inflammatory significance.
Asunto(s)
Hemodiafiltración/métodos , Soluciones para Hemodiálisis/administración & dosificación , Inflamación/etiología , Acetatos , Anciano , Estudios Cruzados , Femenino , Humanos , Inflamación/sangre , MasculinoRESUMEN
BACKGROUND: Body temperature tends to increase during conventional haemodialysis; this might interfere with normal cardiovascular response to dialytic ultrafiltration, thus facilitating the occurrence of symptomatic hypotension. Putative factors responsible for changes in thermal balance during haemodialysis include heat load from the dialysis bath, reduction in convective heat loss secondary to skin vessel vasoconstriction, heat overproduction due to central stimulation by bioincompatibility reactions to the filter membranes. The aim of the present study was twofold: to define thermal energy balance (ET) during dialysis and to investigate the effect of membrane bioincompatibility on energy balance METHODS: We measured ET in 12 patients (9M, 3F) during two identical dialysis sessions, differing only in the membrane composition of the filters used: cuprophane 1.3- 1.6 mq and LF polysulphone 1.3- 1.6 mq. Thermal energy balance studies were performed by the Blood Temperature Monitor (Fresenius Medical Care) under conditions in which the core temperature of the patients was maintained unchanged from the start to the end of the dialysis procedure. RESULTS: Arterial blood temperatures were constant, while dialysate and venous blood temperatures progressively decreased (from 36.9 to 35.4 C and from 36.5 to 35.1 C for cuprophane; from 36.9 to 35.2 and from 36.9 to 35.1 for polysulphone membrane). Mean thermal energy transfer was negative (removal of energy from the patients to the extracorporeal circuit) with both filters, equal to 146 KJ with cuprophane and to 163 KJ with polysulphone. When a stepwise multiregression analysis was applied, hourly energy transfer (ET) was significantly and independently correlated with both ultrafiltration rate (UF=% b.w.) and heart rate changes (HR) according to the equation: ET= -92.03+41.29 UF+1.04 HR (p<0.0003). Conclusions. In this study we present experimental evidence that increased body temperature during dialysis is not caused by heat load from the dialysis bath, nor by heat over production secondary to bioincompatibility reactions. Consequently, haemodynamic responses to dialytic ultrafiltration may be regarded as the main regulatory factor of thermal balance.
Asunto(s)
Temperatura Corporal , Celulosa , Celulosa/análogos & derivados , Hemodinámica , Membranas Artificiales , Polímeros , Diálisis Renal , Sulfonas , Temperatura , Anciano , Anciano de 80 o más Años , Materiales Biocompatibles/química , Celulosa/química , Convección , Metabolismo Energético , Femenino , Fiebre/etiología , Calor , Humanos , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/fisiopatología , Fallo Renal Crónico/terapia , Masculino , Persona de Mediana Edad , Polímeros/química , Diálisis Renal/efectos adversos , Diálisis Renal/instrumentación , Sulfonas/químicaRESUMEN
It has been reported that sodium intake can be estimated in dialysis patients by the increment in the body sodium pool from the end of a dialysis session to the beginning of the following one. To verify the reliability of this method we compared the sodium intake, estimated by the interdialytic changes in plasma sodium concentration (C) and body water volume (V), to sodium removal during three consecutive sessions. For this purpose we investigated 9 nondiabetic patients, 5 females and 4 males, under chronic hemofiltration treatment. Sodium intake was estimated by the formula (C(pre) V(pre)) - (C(post) V(post)) using a flame photometer and electrical bioimpedance to determine the plasma sodium concentration and total body water, respectively. Sodium removal was calculated by the difference between sodium loss into the ultrafiltrate and sodium gain with the reinfusion fluid. The mean values of sodium intake calculated during the three intervals corresponded with the sodium losses measured during the three hemofiltration sessions in each patient (338+/-55 vs. 329+/-67 mEq; r = 0.92, p<0.0001). A direct relationship was also observed between sodium intake and both interdialytic body weight increase (r = 0.89, p< 0.0001) and fluid loss during the sessions (r = 0.88, p<0.0001). This data demonstrates that sodium intake can be properly estimated by the interdialytic changes in body water and plasma sodium concentrations. They also suggest that fluid intake may be influenced by sodium consumption and that sodium intake monitoring could be useful for the control of excessive interdialytic fluid gain.