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BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD), affects approximately 18.6 million individuals worldwide, poses an important healthcare challenge. Despite the established efficacy of both high-intensity statin monotherapy (HIS) and moderate-intensity statin plus ezetimibe (MIS+EZT) in ASCVD management, the optimal treatment strategy remains unclear. PURPOSE: This meta-analysis seeks to assess the impact of moderate-intensity statin plus ezetimibe (MIS+EZT) versus high-intensity statin monotherapy (HIS) on LDL < 70mg/dl; Total Cholesterol; LDL; High Density Cholesterol (HDL) and triglycerides levels. Our goal is to synthesize the existing evidence and pinpoint areas that warrant further investigation. METHODS: A thorough literature search was conducted across PubMed, Scopus, Web of Science, and the Cochrane databases, focusing on studies that compared the effects of moderate-intensity statins plus ezetimibe with high-intensity statin monotherapy in ASCVD patients. RESULTS: In the 13 included studies, involving 8,592 patients, of which 4,525 (52.67%) received moderate-intensity statin plus ezetimibe treatment. The follow-up period ranged from 12 to 219 weeks, with participant ages varying from 66 to 76.5 years in the MIS+EZT group and from 67 to 75.9 years in the HIS group. Analysis revealed significant MIS+EZT-associated with greater percentages in Low Density Lipoprotein (LDL) < 70 (Odds Ratio (OR) 1.76; 95% CI [1.26; 2.45]; p=0.001; I²=73%), LDL reduction (Mean Difference (MD) -5.05 mg/dL; 95% CI [-9.02;-1.07]; p< 0.013; I²=56%;); Total Cholesterol reduction (MD -7.91 mg/ dL; 95% CI [-14.90; -0.91]; p< 0.027; I²=60%); Triglycerides reduction (MD -8.20 mg/ dL; 95% CI [-13.05; -3.35]; p< 0.001; I²=2%;); There was no statistical difference between groups in Drug Adverse reaction (Risk Ratio (RR) 1.19; 95% CI [0.79; 1.78]; p=0.404; I²=0%); and Drug intolerance (RR 0.78 ; 95% CI [0.32; 1.92]; p=0.584; I²=35%). CONCLUSIONS: This meta-analysis underscores the effectiveness of MIS+EZT in enhancing significant clinical outcomes for ASCVD patients, as evidenced by improvements in a greater percentage of patients achieved the LDL < 70 target, LDL, Total Cholesterol and Triglycerides levels . Importantly, there were no significant differences in the occurrence of overall adverse events and adverse drug reactions between the two groups.
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Terapéutica , Enfermedades Cardiovasculares , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Lipoproteínas LDLRESUMEN
Many anuran amphibians deposit their eggs in foam nests, biostructures that help protect the eggs and tadpoles from predators. Currently, there are no other identification and description studies of the cultivable microbiota role in the nests of the Leptodactylid frogs such as Physalaemus cuvieri, Leptodactylus vastus and Adenomera hylaedactyla. This study aimed to isolate and identify the culturable bacteria from these three anuran species' nests, as well as to prospect enzymes produced by this microbiota. Foam nests samples and environmental samples were diluted and viable cell count was determined. Bacterial morphotypes from foam nest samples were isolated through spread plate technique. Isolates' DNAs were extracted followed by rRNA 16S gene amplification and Sanger sequencing. To evaluate their enzymatic potential, the isolates were cultured in ATGE medium supplemented with starch (0.1% w/v), gelatin (3% w/v) and skimmed milk (1% w/v), to verify amylase and protease activity. A total of 183 bacterial morphotypes were isolated, comprising 33 bacterial genera. Proteobacteria phylum was the most abundant in all the three nests (79%). The genera Pseudomonas and Aeromonas were the most abundant taxon in P. cuvieri and L. vastus. In A. Hylaedactyla, were Enterobacter and Bacillus. Regarding enzymatic activities, 130 isolates displayed protease activity and 45 isolates were positive for amylase activity. Our results provide unprecedented information concerning culturable bacterial microbiota of the foam nests of the Leptodactylid frogs, as well as their potential for biomolecules of biotechnological interest.
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Anuros , Bacterias , Animales , Anuros/microbiología , Bacterias/clasificación , Bacterias/aislamiento & purificación , ARN Ribosómico 16S/genética , Comportamiento de Nidificación/fisiología , Microbiota , ADN Bacteriano/análisisRESUMEN
Mucormycosis is an extremely aggressive fungal disease with a high mortality rate, especially in people with compromised immune systems. Most cases of mucormycosis are caused by the fungus Rhizopus oryzae. The treatments used are based on high doses of antifungals, associated with surgical resections, when it is possible. However, even with this aggressive treatment, the estimated attributable mortality rate is high. There is therefore a need to develop adjuvant treatments. Photodynamic Inactivation (PDI) may be an auxiliary therapeutic option for mucormycosis. Due to the lack of reports in the literature on the morphology and photodynamic inactivation of R. oryzae, characterization of the fungus using Confocal Microscopy and Transmission Electron Microscopy, and different protocols using Photodithazine® (PDZ), a chlorin e6 compound, as a photosensitizer, were performed. The fungus growth rate under different concentrations and incubation times of the photosensitizer and its association with the surfactant Sodium Dodecyl Sulphate (SDS) was evaluated. For the hyphae, both in the light and dark phases, in the protocols using only PDZ, no effective photodynamic response was observed. Meanwhile with the combination of SDS 0.05% and PDZ, inhibition growth rates of 98% and 72% were achieved for the white and black phase, respectively. In the conidia phase, only a 1.7 log10 reduction of the infective spores was observed. High concentration of melanin and the complex and resistant structures, especially at the black phase, results in a high limitation of the PDI inactivation response. The combined use of the SDS resulted in an improved response, when compared to the one obtained with the amphotericin B treatment.
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Fármacos Fotosensibilizantes , Rhizopus oryzae , Fármacos Fotosensibilizantes/farmacología , Fármacos Fotosensibilizantes/química , Rhizopus oryzae/efectos de los fármacos , Porfirinas/farmacología , Porfirinas/química , Fotoquimioterapia , Antifúngicos/farmacología , Antifúngicos/química , Dodecil Sulfato de Sodio/farmacología , Dodecil Sulfato de Sodio/química , Luz , Pruebas de Sensibilidad MicrobianaRESUMEN
INTRODUÇÃO: Dados de estudos randomizados avaliando os efeitos a longo prazo da cirurgia bariátrica no controle e remissão da hipertensão (HTN) são escassos. O seguimento de curto e médio prazo do Estudo GATEWAY (1 e 3 anos) mostrou melhora significativa e remissão da hipertensão após a cirurgia bariátrica. Aqui, apresentamos os dados de acompanhamento de 5 anos deste estudo. MÉTODOS: Conduzimos um ensaio clínico randomizado, em um centro único, fase III, paralelo e aberto. Pacientes com obesidade graus 1 e 2, tomando no mínimo 2 medicamentos anti-hipertensivos em doses máximas para hipertensão, foram alocados aleatoriamente para Bypass gástrico em Y de Roux (RYGB) combinado com tratamento clínico (TC) ou TC (estilo de vida/aconselhamento nutricional) isoladamente. O desfecho primário foi a redução de pelo menos 30% do total de anti-hipertensivos, mantendo níveis controlados de pressão arterial (PA)<140/90mmHg. A análise principal seguiu o princípio de intenção de tratar modificada e os valores ausentes foram imputados com a técnica de imputação múltipla. Os desfechos secundários incluíram vários biomarcadores. RESULTADOS: Foram incluídos 100 pacientes (76% mulheres, idade: 43,8±9,2 anos, índice de massa corporal, IMC: 36,9±2,7Kg/ m2). Após 5 anos, o IMC foi de 27,8±3,8kg/m2 para RYGB e 36,4±3,9kg/m2 para TC (P<0,001). 82,7% dos pacientes do grupo RYGB atingiram o desfecho primário, enquanto no grupo TC foram 14,7% (rate ratio 5,6 [95% CI]: 2,8 a 11,1; P<0,001) (Fig. A). A mediana (IQR) de número de drogas foi 1 (0-1) e 3 (3-4) para RYGB e TC, respectivamente. As taxas de remissão da hipertensão foram de 46,4 e 2% para RYGB e TC (Fig. B), respectivamente (P<0,001); A análise de sensibilidade considerando apenas os casos com seguimento concluído (n=69) revelou resultados consistentes. Os desfechos secundários nos grupos RYGB e TC, aos 60 meses, foram: circunferência abdominal 88,05 ± 9,84cm e 109,44 ± 9,76cm (P<0,001) ; hemoglobina glicada 5,4 ± 0,43% e 5,96 ± 0,9% (P<0,001) ; insulina 6,41 ± 2,46mU/L e 24,65 ± 16,57mU/L (P<0,001) ); LDL colesterol 93.61 ± 31.06mg/dL e 109.94 ± 37.58mg/dL (P=0,022); triglicerídeos 86,76 ± 38,45mg/dL e 140,33 ± 59,11 mg/dL (P<0,001); proteína C reativa de alta sensibilidade 0,81 ± 0,76mg/L e 6,13 ± 6,22mg/L (P=0,005), respectivamente. CONCLUSÕES: A cirurgia bariátrica é uma estratégia eficaz e duradoura no controle da PA com menor número ou nenhum medicamento anti-hipertensivo e na melhora do perfil metabólico e inflamatório em pacientes com obesidade graus 1 ou 2 e hipertensão.
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Recent evidence shows that heteroclinic bifurcations in magnetic islands may be caused by the amplitude variation of resonant magnetic perturbations in tokamaks. To investigate the onset of these bifurcations, we consider a large aspect ratio tokamak with an ergodic limiter composed of two pairs of rings that create external primary perturbations with two sets of wave numbers. An individual pair produces hyperbolic and elliptic periodic points, and its associated islands, that are consistent with the Poincaré-Birkhoff fixed-point theorem. However, for two pairs producing external perturbations resonant on the same rational surface, we show that different configurations of isochronous island chains may appear on phase space according to the amplitude of the electric currents in each pair of the ergodic limiter. When one of the electric currents increases, isochronous bifurcations take place and new islands are created with the same winding number as the preceding islands. We present examples of bifurcation sequences displaying (a) direct transitions from the island chain configuration generated by one of the pairs to the configuration produced by the other pair, and (b) transitions with intermediate configurations produced by the limiter pairs coupling. Furthermore, we identify shearless bifurcations inside some isochronous islands, originating nonmonotonic local winding number profiles with associated shearless invariant curves.
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INTRODUÇÃO E/OU FUNDAMENTO: O Hiperaldosteronismo Primário (HP) é a principal causa de hipertensão arterial (HA) endócrina e estima-se que até 20% dos hipertensos resistentes possa ser portador da condição. Indivíduos com HP apresentam um risco cardiovascular (CV) de 4 a 12 vezes mais elevado que portadores de HA primária. Apesar disso, o HP continua largamente subdiagnosticado, em parte pela falta de padronização de triagem, diagnóstico e tratamento. MÉTODOS: A partir de processo de revisão sistemática das diretrizes nacionais e internacionais de HA e HP, elaboramos um algoritmo ilustrando a Jornada Ideal do Paciente com HP. A busca foi realizada em idioma português e inglês na base MEDLINE/PubMed. Selecionamos as publicações dos últimos 5 anos. O processo foi conduzido simultaneamente por dois pesquisadores e os resultados confrontados. RESULTADOS: Um total de 3.476 artigos foram triados para HA e 1.238 para HP. Após revisão e confrontação foram incluídas 22 diretrizes de HA e 9 diretrizes de HP. A partir da análise dos documentos selecionados a Jornada Ideal do Paciente com HP foi segmentada em 7 etapas: 1-Suspeita (definidas as Red Flags); 2-Rastreio (Concentração Plasmática de Aldosterona e Renina ou Atividade da Renina Plasmática); 3-Diagnóstico Laboratorial (critérios e testes confirmatórios); 4-Diagnóstico Anatômico (exames de imagem); 5-Tratamento Cirúrgico (critérios de encaminhamento); 6-Tratamento Clínico (metas terapêuticas e ajuste posológico); 7-Seguimento (critérios e prazos de reavaliação periódica). Com o intuito de acelerar a jornada do paciente, para cada etapa foram definidos gatilhos e ações esperadas, assim como prazos ideais e prazos razoáveis. CONCLUSÕES: Com base nas melhores evidências atualmente disponíveis e a partir de revisão sistemática das diretrizes vigentes, apresentamos uma proposta de Jornada Ideal do Paciente com HP, como modelo para a implantação de serviços especializados para o rastreio, o diagnóstico, o tratamento e o follow-up do HA.
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INTRODUÇÃO: Dados de estudos randomizados avaliando os efeitos a longo prazo da cirurgia bariátrica no controle e remissão da hipertensão (HTN) são escassos. O seguimento de curto e médio prazo do Estudo GATEWAY (1 e 3 anos) mostrou melhora significativa e remissão da hipertensão após a cirurgia bariátrica. Aqui, apresentamos os dados de acompanhamento de 5 anos deste estudo. MÉTODOS: Conduzimos um ensaio clínico randomizado, em um centro único, fase III, paralelo e aberto. Pacientes com obesidade graus 1 e 2, tomando no mínimo 2 medicamentos anti-hipertensivos em doses máximas para hipertensão, foram alocados aleatoriamente para Bypass gástrico em Y de Roux (RYGB) combinado com tratamento clínico (TC) ou TC (estilo de vida/aconselhamento nutricional) isoladamente. O desfecho primário foi a redução de pelo menos 30% do total de anti-hipertensivos, mantendo níveis controlados de pressão arterial (PA) <140/90mmHg. A análise principal seguiu o princípio de intenção de tratar modificada e os valores ausentes foram imputados com a técnica de imputação múltipla. Os desfechos secundários incluíram vários biomarcadores. RESULTADOS: Foram incluídos 100 pacientes (76% mulheres, idade: 43,8±9,2 anos, índice de massa corporal, IMC: 36,9±2,7Kg/ m2). Após 5 anos, o IMC foi de 27,8±3,8kg/m2 para RYGB e 36,4±3,9kg/m2 para TC (P<0,001). A análise de sensibilidade considerando apenas os casos com seguimento concluído (n=69) revelou resultados consistentes. Os desfechos secundários nos grupos RYGB e TC, aos 60 meses, foram: circunferência abdominal 88,05 ± 9,84cm e 109,44 ± 9,76cm (P<0,001) ; hemoglobina glicada 5,4 ± 0,43% e 5,96 ± 0,9% (P<0,001); insulina 6,41 ± 2,46mU/L e 24,65 ± 16,57mU/L (P<0,001); LDL colesterol 93.61 ± 31.06mg/dL e 109.94 ± 37.58mg/dL (P=0,022); triglicerídeos 86,76 ± 38,45mg/dL e 140,33 ± 59,11 mg/dL (P<0,001); proteína C reativa de alta sensibilidade 0,81 ± 0,76mg/L e 6,13 ± 6,22mg/L (P=0,005), respectivamente. CONCLUSÕES: A cirurgia bariátrica é uma estratégia eficaz e duradoura no controle da PA com menor número ou nenhum medicamento anti-hipertensivo e na melhora do perfil metabólico e inflamatório em pacientes com obesidade graus 1 ou 2 e hipertensão.
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The objective of this study was to characterize the dynamics of food passage in the gastrointestinal tract (GIT) of Japanese quail. A randomized design was used with four treatments and four experimental units with one bird each, nine of which were measured in time. The ingredients used were albumin, starch, cellulose, and soybean oil. Suspensions containing barium sulfate and saline were prepared, except for soybean oil. For each bird, 2.5 mL of the suspension was administered directly to the crop. Dual-energy absorptiometry (DEXA) was used to quantify the passage of food. The birds were sedated and maintained under inhalation anesthesia during the scan. Measurements were taken at intervals of 0.5, 1, 2, 4, 6, 8, 10, 12, and 24 h. The variables identified were passage time, first quality, and the average time of each variable. Based on these results, the ingredients may show differences in dynamic passing on the Japanese quail GIT. The duration of the first attempt was 32 min, ranging from 21 to 44 min. The average time value of food choice was close to 10.8 h and varied according to the ingredient from 8.45-12.16 h. Among the variables, soybean oil presented values ââthat denote a fast passage in the GIT, while albumin presented values ââthat denote a slower passage. The dynamics of food passage in the GIT of Japanese quails varies according to the chemical composition of the ingredients.(AU)
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Animales , Sulfato de Bario/química , Coturnix/fisiología , Absorción Gastrointestinal/fisiología , Biomarcadores/análisisRESUMEN
Candida albicans is the most frequently isolated opportunistic pathogen in the female genital tract, with 92.3% of cases in Brazil associated with vulvovaginal candidiasis (VVC). Linalool is a monoterpene compound from plants of the genera Cinnamomum, Coriandrum, Lavandula, and Citrus that has demonstrated a fungicidal effect on strains of Candida spp., but its mechanism of action is still unknown. For this purpose, broth microdilution techniques were applied, as well as molecular docking in a predictive manner for this mechanism. The main results of this study indicated that the C. albicans strains analyzed were resistant to fluconazole and sensitive to linalool at a dose of 256 µg/mL. Furthermore, the increase in the minimum inhibitory concentration (MIC) of linalool in the presence of sorbitol and ergosterol indicated that this molecule possibly affects the cell wall and plasma membrane integrity of C. albicans. Molecular docking of linalool with proteins that are key in the biosynthesis and maintenance of the cell wall and the fungal plasma membrane integrity demonstrated the possibility of linalool interacting with three important enzymes: 1,3-ß-glucan synthase, lanosterol 14α-demethylase, and Δ 14-sterol reductase. In silico analysis showed that this monoterpene has theoretical but significant oral bioavailability, low toxic potential, and high similarity to pharmaceuticals. Therefore, the findings of this study indicated that linalool probably causes damage to the cell wall and plasma membrane of C. albicans, possibly by interaction with important enzymes involved in the biosynthesis of these fungal structures, in addition to presenting low in silico toxic potential.
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Candida albicans , Fluconazol , Monoterpenos Acíclicos , Antifúngicos/farmacología , Farmacorresistencia Fúngica , Fluconazol/farmacología , Pruebas de Sensibilidad Microbiana , Simulación del Acoplamiento Molecular , Monoterpenos/farmacologíaRESUMEN
OBJECTIVE: To compare clinical and laboratory data obtained from patients with primary antiphospholipid syndrome (pAPS) above and below 165 cm of height. PATIENTS AND METHODS: A cross-sectional study with 66 (83.3% female) pAPS patients was performed. Demographic, clinical, drug use, and antiphospholipid antibodies data were evaluated. Patients were subdivided into one of two groups: pAPS ≥ 165 cm and pAPS < 165 cm and compared. RESULTS: In this sample 19/66 (28.8%) of patients were ≥ 165 cm and 47 were < 165 cm of height. Primary APS > 165 cm exhibited a lower frequency of female sex (52.6% vs. 95.7%, p<0.0001) and abortions (0 vs. 34%, p=0.008). A significant higher frequency of antimalarial use was seen in taller patients compared to those < 165 cm (36.8% vs. 14.9%, p=0.04). Furthermore, the analysis of females showed lower mean age (32.3 ± 9.9 vs. 41.3 ± 10.5, p=0.016), higher weight (85.5 ± 25.3 vs. 69.7 ± 17.6 kg, p= 0.023), higher frequency of venous events (100% vs. 66.7%, p=0.025) and lower rate of stroke (10% vs. 44.4%, p=0.043) in taller female than in the smaller. CONCLUSIONS: This study used a systematic design to show that different heights in individuals with pAPS are associated with different diseases' expressions. When analyzing females exclusively, the taller ones were younger, heavier with more venous events, and more minor strokes than the smaller ones.
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Aborto Espontáneo , Síndrome Antifosfolípido , Anticuerpos Antifosfolípidos , Síndrome Antifosfolípido/complicaciones , Síndrome Antifosfolípido/diagnóstico , Estudios Transversales , Femenino , Humanos , Masculino , EmbarazoRESUMEN
Candida albicans is the most frequently isolated opportunistic pathogen in the female genital tract, with 92.3% of cases in Brazil associated with vulvovaginal candidiasis (VVC). Linalool is a monoterpene compound from plants of the genera Cinnamomum, Coriandrum, Lavandula, and Citrus that has demonstrated a fungicidal effect on strains of Candida spp., but its mechanism of action is still unknown. For this purpose, broth microdilution techniques were applied, as well as molecular docking in a predictive manner for this mechanism. The main results of this study indicated that the C. albicans strains analyzed were resistant to fluconazole and sensitive to linalool at a dose of 256 µg/mL. Furthermore, the increase in the minimum inhibitory concentration (MIC) of linalool in the presence of sorbitol and ergosterol indicated that this molecule possibly affects the cell wall and plasma membrane integrity of C. albicans. Molecular docking of linalool with proteins that are key in the biosynthesis and maintenance of the cell wall and the fungal plasma membrane integrity demonstrated the possibility of linalool interacting with three important enzymes: 1,3-β-glucan synthase, lanosterol 14α-demethylase, and Δ 14-sterol reductase. In silico analysis showed that this monoterpene has theoretical but significant oral bioavailability, low toxic potential, and high similarity to pharmaceuticals. Therefore, the findings of this study indicated that linalool probably causes damage to the cell wall and plasma membrane of C. albicans, possibly by interaction with important enzymes involved in the biosynthesis of these fungal structures, in addition to presenting low in silico toxic potential.
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We analyze nonlinear aspects of the self-consistent wave-particle interaction using Hamiltonian dynamics in the single wave model, where the wave is modified due to the particle dynamics. This interaction plays an important role in the emergence of plasma instabilities and turbulence. The simplest case, where one particle (N=1) is coupled with one wave (M=1), is completely integrable, and the nonlinear effects reduce to the wave potential pulsating while the particle either remains trapped or circulates forever. On increasing the number of particles ( N=2, M=1), integrability is lost and chaos develops. Our analyses identify the two standard ways for chaos to appear and grow (the homoclinic tangle born from a separatrix, and the resonance overlap near an elliptic fixed point). Moreover, a strong form of chaos occurs when the energy is high enough for the wave amplitude to vanish occasionally.
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INTRODUCTION: Familial hypercholesterolemia (FH) is an autosomal dominant genetic disease. The prevalence of FH has previously been reported as 1 in 500 in the general population. This study aimed to evaluate the proprotein convertase subtilisin/kexin 9 (PCSK9) levels, lipid profile and thrombin generation in FH patients undergoing treatment or not. METHODS: Eighty individuals with FH were selected and distributed in 2 groups: individuals treated with statins alone or conjugate therapy (statin + ezetimibe) (T = 53) and those non treated (NT = 27). PCSK9 levels were determined by ELISA, the lipid profile by colorimetric enzyme method and thrombin generation assay (TGA) by CAT method. RESULTS: Individuals treated with conjugate therapy (statin + ezetimibe) showed a significant reduction in the levels of total cholesterol (TC) low density lipoprotein cholesterol (LDLc) and in the potential for thrombin generation (ETP with low and high concentration of tissue factor), compared to the treated individuals with monotherapy (statins). PCSK9 was positively correlated with increased levels of TC, LDLc and triglycerides, while TGA parameters were positively correlated with PCSK9 and lipid profile. CONCLUSION: PCSK9 levels appear to be associated with components of the lipid and hemostatic profiles, in addition to being influenced by age. In general, our findings suggest that combined therapy for the treatment of FH is associated with a significant improvement in both lipid and hemostatic profiles assessed by TGA, suggesting a reduction in atherogenic and thrombogenic risks and, therefore, more promising compared to the use of statin monotherapy.
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Anticolesterolemiantes , Hiperlipoproteinemia Tipo II , Anticolesterolemiantes/uso terapéutico , LDL-Colesterol , Humanos , Hiperlipoproteinemia Tipo II/tratamiento farmacológico , Proproteína Convertasa 9 , TrombinaRESUMEN
This study aimed to evaluate the impact of minimally invasive partial pericardiotomy on echocardiographic variables of morphometry and function in healthy horses. Minimally invasive pericardiotomy was performed in six healthy horses. Echocardiographic evaluation was executed in different moments: prior to the surgical procedure (M0); 24 hours post procedure (M1); 72 hours post procedure (M2) and 28 days post procedure (M3). The following variables were measured: Right ventricular internal diameter in diastole and systole (RVd and RVs), interventricular septum thickness in diastole and systole (IVSd and IVSs), left ventricular internal diameter in diastole and systole (LVd and LVs), left ventricular free wall thickness in diastole and systole (LVFWd and LVFWs), aortic root diameter (Ao) and left atrial diameter (LA). From this data, the following variables were calculated: fractional shortening (FS%), fractional thickening of the interventricular septum (IVS%), fractional thickening of the left ventricular free wall (LVFW%) and the relationship between left atrial and aortic diameters (LA/Ao). After 28 days, a new thoracoscopy was performed for inspection of the thoracic cavity. In M1 and M2 ECO evaluations, a statistically significant change in LVFW and a decrease in RVd, LVd, LVFWs, LA, LVs, FS% and IVS was documented. Pericardiotomy is a promising technique in horses, with minor postoperative complication. The variations in the echocardiographic parameters were transient and did not cause hemodynamic damage to the animals.(AU)
O objetivo do presente estudo foi avaliar o impacto da pericardiotomia parcial minimamente invasiva sobre as variáveis ecocardiográficas morfométricas e funcionais em cavalos, visto que não há nenhum trabalho que tenha avaliado o impacto da pericardiotomia na espécie equina. Foram utilizados seis cavalos hígidos, nos quais se realizou pericardiotomia minimamente invasiva. Em todos eles, foi efetuado exame ecocardiográfico em diferentes momentos: previamente ao procedimento cirúrgico (M0); 24 horas após (M1); 72 horas após (M2) e 28 dias após (M3). Foram mensurados: diâmetro interno do ventrículo direito (VDd e VDs), espessura do septo interventricular (SIVd e SIVs), diâmetro interno do ventrículo esquerdo (VEd e VEs), espessura da parede livre do ventrículo esquerdo (PLVEd e PLVEs), diâmetro interno da aorta (Ao) e diâmetro atrial esquerdo (AE). Foram calculadas as variáveis fração de encurtamento (FEC%), espessamento fracional do septo interventricular (SIV%), espessamento fracional da parede livre do ventrículo esquerdo (PLVE%) e relação entre diâmetro do átrio esquerdo e diâmetro aórtico (AE/Ao). Após 28 dias, realizou-se nova toracoscopia para inspeção da cavidade torácica. Nas avaliações do ECO no M1 e no M2, houve alteração estatisticamente significativa no PLVE em diástole (28±5,5 e 31,7±2, respectivamente) e diminuição dos parâmetros VDd,(30,1±11,6 e 31,7± 10,7) VEd (113,3±21 e 121,7±13,7), PLVEs (42±8,2 e 43,9±2,8), AE (78,5±6,1 e 82,7±4,7), VEs (74,1±16 e 71,5±9,3), FEC (34,4±10,2 e 41,2±5,7) e SIV (27,1±8,7 e 42,3±27,9). A técnica de pericardiotomia empregada mostrou-se promissora em equinos. As variações dos parâmetros ecocardiográficos foram transitórias, não causando prejuízos hemodinâmicos aos animais.(AU)
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Animales , Pericardiectomía/veterinaria , Pruebas de Función Cardíaca/veterinaria , Caballos/cirugía , Toracoscopía/veterinaria , Ecocardiografía/veterinariaRESUMEN
Abstract Little is known regarding whether photodynamic therapy (PDT)-induced cell death can substantially compromise macrophages (MΦ), which are important cells in PDT-induced immune responses. Here, parameters of PDT-mediated MΦ cytotoxicity and cytokine production in response to protoporphyrin IX (PpIX) were evaluated. Peritoneal MΦ from BALB/c mice were stimulated in vitro with PDT, light, PpIX, or lipopolysaccharide (LPS). After that, cell viability, lipid peroxidation, Nitric Oxide (NO), DNA damage, TNF-α, IL-6 and IL-10 were evaluated. Short PDT exposure reduced cell viability by 10-30%. There was a two-fold increase in NO and DNA degradation, despite the non-increase in lipoperoxidation. PDT increased TNF-α and IL-10, particularly in the presence of LPS, and decreased the production of IL-6 to 10-fold. PDT causes cellular stress, induces NO radicals and leads to DNA degradation, generating a cytotoxic microenvironment. Furthermore, PDT modulates pro- and anti-inflammatory cytokines in MΦ.
Resumo Pouco se sabe se a morte celular induzida pela terapia fotodinâmica (PDT) compromete os macrófagos (MΦ), envolvidos nas respostas imunes induzidas pela PDT. Neste estudo, foram avaliados parâmetros de citotoxicidade dos MΦ mediada pela PDT e a produção de citocinas, frente à protoporfirina IX (PpIX). MΦ peritoneais de camundongos BALB/c foram estimulados in vitro com PDT, luz, PpIX ou lipopolissacarídeo (LPS). Após isto, a viabilidade celular (VC), a lipoperoxidação, os níveis de óxido nítrico (NO), de DNA degradado, de TNF-α, IL-6 e IL-10 foram avaliados. A exposição curta à PDT reduziu a VC em 10-30%. Os níveis de NO e de DNA degradado duplicaram, sem aumento da lipoperoxidação. Houve aumento de TNF-α e IL-10, sendo maior na presença de LPS. Já a produção de IL-6 reduziu em dez vezes. A PDT induz estresse celular, gera radicais NO e causa dano ao DNA, tornando o microambiente citotóxico. Ainda, modula citocinas pró e anti-inflamatórias em MΦ.
Asunto(s)
Animales , Conejos , Fotoquimioterapia , Interleucina-10 , Protoporfirinas , Citocinas , Interleucina-6 , Factor de Necrosis Tumoral alfa , Macrófagos , Ratones Endogámicos BALB CRESUMEN
Little is known regarding whether photodynamic therapy (PDT)-induced cell death can substantially compromise macrophages (MΦ), which are important cells in PDT-induced immune responses. Here, parameters of PDT-mediated MΦ cytotoxicity and cytokine production in response to protoporphyrin IX (PpIX) were evaluated. Peritoneal MΦ from BALB/c mice were stimulated in vitro with PDT, light, PpIX, or lipopolysaccharide (LPS). After that, cell viability, lipid peroxidation, Nitric Oxide (NO), DNA damage, TNF-α, IL-6 and IL-10 were evaluated. Short PDT exposure reduced cell viability by 10-30%. There was a two-fold increase in NO and DNA degradation, despite the non-increase in lipoperoxidation. PDT increased TNF-α and IL-10, particularly in the presence of LPS, and decreased the production of IL-6 to 10-fold. PDT causes cellular stress, induces NO radicals and leads to DNA degradation, generating a cytotoxic microenvironment. Furthermore, PDT modulates pro- and anti-inflammatory cytokines in MΦ.
Asunto(s)
Interleucina-10 , Fotoquimioterapia , Animales , Citocinas , Interleucina-6 , Macrófagos , Ratones , Ratones Endogámicos BALB C , Protoporfirinas , Factor de Necrosis Tumoral alfaRESUMEN
Little is known regarding whether photodynamic therapy (PDT)-induced cell death can substantially compromise macrophages (M), which are important cells in PDT-induced immune responses. Here, parameters of PDT-mediated M cytotoxicity and cytokine production in response to protoporphyrin IX (PpIX) were evaluated. Peritoneal M from BALB/c mice were stimulated in vitro with PDT, light, PpIX, or lipopolysaccharide (LPS). After that, cell viability, lipid peroxidation, Nitric Oxide (NO), DNA damage, TNF-, IL-6 and IL-10 were evaluated. Short PDT exposure reduced cell viability by 1030%. There was a two-fold increase in NO and DNA degradation, despite the non-increase in lipoperoxidation. PDT increased TNF- and IL-10, particularly in the presence of LPS, and decreased the production of IL-6 to 10-fold. PDT causes cellular stress, induces NO radicals and leads to DNA degradation, generating a cytotoxic microenvironment. Furthermore, PDT modulates pro- and anti-inflammatory cytokines in M(AU)
Pouco se sabe se a morte celular induzida pela terapia fotodinâmica (PDT) compromete os macrófagos (M), envolvidos nas respostas imunes induzidas pela PDT. Neste estudo, foram avaliados parâmetros de citotoxicidade dos M mediada pela PDT e a produção de citocinas, frente à protoporfirina IX (PpIX). M peritoneais de camundongos BALB/c foram estimulados in vitro com PDT, luz, PpIX ou lipopolissacarídeo (LPS). Após isto, a viabilidade celular (VC), a lipoperoxidação, os níveis de óxido nítrico (NO), de DNA degradado, de TNF-, IL-6 e IL-10 foram avaliados. A exposição curta à PDT reduziu a VC em 10-30%. Os níveis de NO e de DNA degradado duplicaram, sem aumento da lipoperoxidação. Houve aumento de TNF- e IL-10, sendo maior na presença de LPS. Já a produção de IL-6 reduziu em dez vezes. A PDT induz estresse celular, gera radicais NO e causa dano ao DNA, tornando o microambiente citotóxico. Ainda, modula citocinas pró e anti-inflamatórias em M(AU)
Asunto(s)
Animales , Citocinas/análisis , Factor de Necrosis Tumoral alfa/análisis , Interleucina-6 , Interleucina-10 , Macrófagos , Estrés Oxidativo , FotoquimioterapiaRESUMEN
A degeneração mixomatosa valvar mitral (DMVM) costuma ser diagnosticada pelo ecocardiograma, porém o eletrocardiograma (ECG) pode sugerir alterações específicas e auxiliar no diagnóstico e no tratamento. A deflexão intrinsecóide (DI) é uma medida simples do ECG, que representa o início da despolarização ventricular e pode indicar a presença de sobrecargas e hipertrofia no ventrículo esquerdo. O objetivo deste trabalho é comparar dados prévios sobre condição clínica e ecocardiograma de cães com endocardiose de mitral e o valor da deflexão intrinsecóide do ECG, para buscar uma relação de concordância. Foram selecionados os arquivos de 45 cães anteriormente atendidos na rotina clínica do HV-UPFR. A estatística mostrou diferença relevante nos grupos B1, B2 e C nas derivações D2, D3, aVF, rV, V2 e V4 (P<0,05), o que permitiu classificá-los de acordo com o tamanho da DI, e esse resultado correspondeu à classificação do consenso de endocardiose de mitral em cães nesses estágios. Concluiu-se que há um aumento gradativo no valor da DI à medida que a DMVM avança, principalmente nos estágios B1, B2 e C, associado à sobrecarga e à hipertrofia ventricular esquerda, portanto esse parâmetro pode ser usado na classificação da doença.(AU)
The mitral valve myxomatous degeneration (DMVM) is usually diagnosed by echocardiography, however, electrocardiogram (ECG) may suggest specific alterations and aid diagnosis and treatment. Intrinsicoid deflection (DI) is a simple ECG measure that represents the onset of ventricular depolarization and may indicate the presence of overload and hypertrophy in the left ventricle. The objective of this study is to compare previous data on clinical condition and echocardiogram of dogs with mitral endocardiosis and the value of the intrinsicoid deflection from ECG to obtain a concordance relation. The archives of 45 previously examined dogs in the clinical routine of HV-UFPR were selected. The statistic showed a significant difference in groups B1, B2 and C in leads D2, D3, aVF, rV, V2 and V4 (P< 0,05), which allowed to classify them according to the DI size, and this result corresponded to the consensus classification of mitral endocardiosis in dogs at these stages. It was concluded that there is a gradual increase in the value of DI as DMVM progresses, especially in stages B1, B2 and C, associated with left ventricular overload and hypertrophy, so this parameter can be used to classify the disease.(AU)
Asunto(s)
Animales , Perros , Técnicas de Diagnóstico Cardiovascular/veterinaria , Electrocardiografía/veterinaria , Enfermedades de las Válvulas Cardíacas/diagnóstico , Enfermedades de las Válvulas Cardíacas/veterinaria , Válvula MitralRESUMEN
A degeneração mixomatosa valvar mitral (DMVM) costuma ser diagnosticada pelo ecocardiograma, porém o eletrocardiograma (ECG) pode sugerir alterações específicas e auxiliar no diagnóstico e no tratamento. A deflexão intrinsecóide (DI) é uma medida simples do ECG, que representa o início da despolarização ventricular e pode indicar a presença de sobrecargas e hipertrofia no ventrículo esquerdo. O objetivo deste trabalho é comparar dados prévios sobre condição clínica e ecocardiograma de cães com endocardiose de mitral e o valor da deflexão intrinsecóide do ECG, para buscar uma relação de concordância. Foram selecionados os arquivos de 45 cães anteriormente atendidos na rotina clínica do HV-UPFR. A estatística mostrou diferença relevante nos grupos B1, B2 e C nas derivações D2, D3, aVF, rV, V2 e V4 (P<0,05), o que permitiu classificá-los de acordo com o tamanho da DI, e esse resultado correspondeu à classificação do consenso de endocardiose de mitral em cães nesses estágios. Concluiu-se que há um aumento gradativo no valor da DI à medida que a DMVM avança, principalmente nos estágios B1, B2 e C, associado à sobrecarga e à hipertrofia ventricular esquerda, portanto esse parâmetro pode ser usado na classificação da doença.(AU)
The mitral valve myxomatous degeneration (DMVM) is usually diagnosed by echocardiography, however, electrocardiogram (ECG) may suggest specific alterations and aid diagnosis and treatment. Intrinsicoid deflection (DI) is a simple ECG measure that represents the onset of ventricular depolarization and may indicate the presence of overload and hypertrophy in the left ventricle. The objective of this study is to compare previous data on clinical condition and echocardiogram of dogs with mitral endocardiosis and the value of the intrinsicoid deflection from ECG to obtain a concordance relation. The archives of 45 previously examined dogs in the clinical routine of HV-UFPR were selected. The statistic showed a significant difference in groups B1, B2 and C in leads D2, D3, aVF, rV, V2 and V4 (P< 0,05), which allowed to classify them according to the DI size, and this result corresponded to the consensus classification of mitral endocardiosis in dogs at these stages. It was concluded that there is a gradual increase in the value of DI as DMVM progresses, especially in stages B1, B2 and C, associated with left ventricular overload and hypertrophy, so this parameter can be used to classify the disease.(AU)