Assuntos
Carcinoma Hepatocelular , Hepatite C Crônica , Neoplasias Hepáticas , Antivirais/uso terapêutico , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/patologia , Hepacivirus , Hepatite C Crônica/complicações , Hepatite C Crônica/tratamento farmacológico , Humanos , Neoplasias Hepáticas/complicaçõesRESUMO
Purpose Hyper-attenuating lesions, or contrast staining, on a non-contrast brain computed tomography (NCCT) scan have been investigated as a predictor for hemorrhagic transformation after endovascular treatment of acute ischemic stroke (AIS). However, the association of hyper-attenuating lesions and final ischemic areas are poorly investigated in this setting. The aim of the present study was to assess correlations between hyper-attenuating lesions and final brain infarcted areas after thrombectomy for AIS. Methods Data from patients with AIS of the anterior circulation who underwent endovascular treatment were retrospectively assessed. Images of the brain NCCT scans were analyzed in the first hours and late after treatment. The hyper-attenuating areas were compared to the final ischemic areas using the Alberta Stroke Program Early CT Score (ASPECTS). Results Seventy-one of the 123 patients (65.13%) treated were included. The association between the hyper-attenuating region in the post-thrombectomy CT scan and final brain ischemic area were sensitivity (58.3% to 96.9%), specificity (42.9% to 95.6%), positive predictive values (71.4% to 97.7%), negative predictive values (53.8% to 79.5%), and accuracy values (68% to 91%). The highest sensitivity values were found for the lentiform (96.9%) and caudate nuclei (80.4%) and for the internal capsule (87.5%), and the lowest values were found for the M1 (58.3%) and M6 (66.7%) cortices. Conclusions Hyper-attenuating lesions on head NCCT scans performed after endovascular treatment of AIS may predict final brain infarcted areas. The prediction appears to be higher in the deep brain regions compared with the cortical regions.
Assuntos
Infarto Encefálico/diagnóstico por imagem , Infarto Encefálico/terapia , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/terapia , Angiografia Cerebral/métodos , Angiografia por Tomografia Computadorizada/métodos , Procedimentos Endovasculares/métodos , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/terapia , Trombectomia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Resultado do TratamentoRESUMO
Hypercholesterolemia is a metabolic disorder characterized by high levels of low-density lipoprotein and blood cholesterol, causing inflammatory lesion. Purinergic signaling modulates the inflammatory and immune responses through adenine nucleotides and nucleoside. Guaraná has hypocholesterolemic and antiinflammatory properties. Considering that there are few studies demonstrating the effects of guaraná powder on the metabolism of adenine nucleotides, we investigated its effects on the activity of ecto-nucleoside triphosphate diphosphohydrolase (E-NTPDase) and ecto-adenosine deaminase activity in lymphocytes of rats with diet-induced hypercholesterolemia. The rats were divided into hypercholesterolemic and normal diet groups. Each group was subdivided by treatment: saline, guaraná powder 12.5, 25, or 50 mg/kg/day and caffeine concentration equivalent to highest dose of guaraná, fed orally for 30 days. An increase in adenosine triphosphate hydrolysis was observed in the lymphocytes of rats with hypercholesterolemia and treated with 25 or 50 mg/kg/day when compared with the other groups. The hypercholesterolemic group treated with the highest concentration of guaraná powder showed decreased ecto-adenosine deaminase activity compared with the normal diet groups. Guaraná was able to reduce the total cholesterol and low-density lipoprotein cholesterol to basal levels in hypercholesterolemic rats. High concentrations of guaraná associated with a hypercholesterolemic diet are likely to have contributed to the reduction of the inflammatory process.
Assuntos
Cafeína/farmacologia , Hipercolesterolemia/tratamento farmacológico , Paullinia/química , Teobromina/farmacologia , Teofilina/farmacologia , Adenosina Desaminase/metabolismo , Animais , Colesterol/sangue , LDL-Colesterol/sangue , Dieta Hiperlipídica , Linfócitos/enzimologia , Masculino , Preparações de Plantas/farmacologia , Ratos , Ratos WistarRESUMO
The present study evaluated electrocardiographic alterations in rats with epilepsy submitted to an acute myocardial infarction (AMI) model induced by cardiac ischemia and reperfusion. Rats were randomly divided into two groups: control (n=12) and epilepsy (n=14). It was found that rats with epilepsy presented a significant reduction in atrioventricular block incidence following the ischemia and reperfusion procedure. In addition, significant alterations were observed in electrocardiogram intervals during the stabilization, ischemia, and reperfusion periods of rats with epilepsy compared to control rats. It was noted that rats with epilepsy presented a significant increase in the QRS interval during the stabilization period in relation to control rats (P<0.01). During the ischemia period, there was an increase in the QRS interval (P<0.05) and a reduction in the P wave and QT intervals (P<0.05 for both) in rats with epilepsy compared to control rats. During the reperfusion period, a significant reduction in the QT interval (P<0.01) was verified in the epilepsy group in relation to the control group. Our results indicate that rats submitted to an epilepsy model induced by pilocarpine presented electrical conductivity alterations of cardiac tissue, mainly during an AMI episode.
Assuntos
Bacteriófago lambda/fisiologia , Escherichia coli/virologia , Proteínas Virais/metabolismo , Sequência de Aminoácidos , Membrana Celular/metabolismo , Regulação Viral da Expressão Gênica/fisiologia , Dados de Sequência Molecular , Proteínas Virais/genética , Liberação de Vírus/fisiologiaRESUMO
The present study evaluated electrocardiographic alterations in rats with epilepsy submitted to an acute myocardial infarction (AMI) model induced by cardiac ischemia and reperfusion. Rats were randomly divided into two groups: control (n=12) and epilepsy (n=14). It was found that rats with epilepsy presented a significant reduction in atrioventricular block incidence following the ischemia and reperfusion procedure. In addition, significant alterations were observed in electrocardiogram intervals during the stabilization, ischemia, and reperfusion periods of rats with epilepsy compared to control rats. It was noted that rats with epilepsy presented a significant increase in the QRS interval during the stabilization period in relation to control rats (P<0.01). During the ischemia period, there was an increase in the QRS interval (P<0.05) and a reduction in the P wave and QT intervals (P<0.05 for both) in rats with epilepsy compared to control rats. During the reperfusion period, a significant reduction in the QT interval (P<0.01) was verified in the epilepsy group in relation to the control group. Our results indicate that rats submitted to an epilepsy model induced by pilocarpine presented electrical conductivity alterations of cardiac tissue, mainly during an AMI episode.
Assuntos
Eletrocardiografia , Epilepsia/complicações , Infarto do Miocárdio/etiologia , Traumatismo por Reperfusão Miocárdica/complicações , Animais , Modelos Animais de Doenças , Condutividade Elétrica , Coração/inervação , Frequência Cardíaca , Masculino , Infarto do Miocárdio/fisiopatologia , Traumatismo por Reperfusão Miocárdica/fisiopatologia , Pilocarpina/administração & dosagem , Ratos Wistar , Fatores de TempoRESUMO
The interaction between the reproductive axis and energy balance suggests that leptin acts as a possible mediator. This hormone acts in the regulation of metabolism, feeding behaviour and reproduction. Animals homozygous for the gene 'ob' (ob/ob) are obese and infertile, and these effects are reversed after systemic administration of leptin. Thus, the present study aimed to determine: (i) whether cells that express leptin also express oestrogen receptors of type-alpha (ER-alpha) or -beta (ER-beta) in the medial preoptic area (MPOA) and in the arcuate (ARC), dorsomedial (DMH) and ventromedial hypothalamic nucleus and (ii) whether there is change in the gene and protein expression of leptin in these brain areas in ovariectomised (OVX) animals when oestrogen-primed. Wistar female rats with normal oestrous cycles or ovariectomised oestrogen-primed or vehicle (oil)-primed were utilised. To determine whether there was a co-expression, immunofluorescence was utilised for double staining. Confocal microscopy was used to confirm the co-expression. The technique of real-time polymerase chain reaction and western blotting were employed to analyse gene and protein expression, respectively. The results obtained showed co-expression of leptin and ER-alpha in the MPOA and in the DMH, as well as leptin and ER-beta in the MPOA, DMH and ARC. However, we did not detect leptin in the MPOA, ARC and DMH using western blotting and there was no statistical difference in leptin gene expression in the MPOA, DMH, ARC, pituitary or adipose tissue between OVX rats treated with oestrogen or vehicle. In conclusion, the results obtained in the present study confirm that the brain is also a source of leptin and reveal co-expression of oestrogen receptors and leptin in the same cells from areas related to reproductive function and feeding behaviour. Although these data corroborate the previous evidence obtained concerning the interaction between the action of brain leptin and reproductive function, the physiological relevance of this interaction remains uncertain and additional studies are necessary to elucidate the exact role of central leptin.
Assuntos
Hipotálamo/metabolismo , Leptina/genética , Área Pré-Óptica/metabolismo , Receptores de Estrogênio/genética , Animais , Estrogênios/farmacologia , Feminino , Expressão Gênica/efeitos dos fármacos , Hipotálamo/efeitos dos fármacos , Leptina/metabolismo , Área Pré-Óptica/efeitos dos fármacos , RNA Mensageiro/metabolismo , Ratos , Ratos Wistar , Receptores de Estrogênio/metabolismo , Reprodução/genética , Distribuição Tecidual/efeitos dos fármacosRESUMO
Balamuthia mandrillaris, a soil amoeba, is the causative agent of Balamuthia granulomatous amoebic encephalitis, a life-threatening brain infection. This amoeba is acquired from contaminated soil and may enter the host through cutaneous lesions or through nasal passages, migrating to the lungs or brain. During invasion, B. mandrillaris has access to components of the extracellular matrix (ECM) of the host. Therefore, we investigated the interaction of B. mandrillaris with 3 ECM glycoproteins (collagen-I, fibronectin and laminin-1) that are encountered in host connective tissues and at the basal lamina. Using optical microscopy, amoeba association on ECM-coated surfaces was examined. Binding of amoebae on laminin was greater than that on collagen or fibronectin. Laminin-adhered B. mandrillaris exhibited elongated and spread forms, distinctive from those observed for amoebae on a plastic surface. Collagen and fibronectin-adhered B. mandrillaris presented elongated shapes with cellular expansions. Binding to collagen, fibronectin, or laminin was inhibited when amoebae were pre-treated with sialic acid. Treatment with galactose resulted in diminished binding of amoebae on laminin, while mannose increased binding in all coating conditions tested. Dependence of divalent cations on amoeba binding was demonstrated for laminin-amoeba interaction. Collectively, the results indicate that B. mandrillaris recognizes specific glycoproteins of the mammalian extracellular matrix.
Assuntos
Encefalite/veterinária , Proteínas da Matriz Extracelular/metabolismo , Glicoproteínas/metabolismo , Lobosea/metabolismo , Amebíase/parasitologia , Amebíase/veterinária , Animais , Cátions Bivalentes/farmacologia , Ácido Edético/farmacologia , Encefalite/parasitologia , Feminino , Laminina/metabolismo , Lobosea/química , Lobosea/isolamento & purificação , Mandrillus , Doenças dos Macacos/parasitologia , Ácido Periódico/farmacologia , Ligação Proteica/efeitos dos fármacos , Tripsina/farmacologiaRESUMO
Although models of high-quality family planning services for men exist in Latin America, few if any have been organized within the complex and resource-constrained national public health systems. This study provides evidence from the Santa Barbara project in southern Brazil showing how vasectomy was introduced into the municipal health system. It demonstrates that once the necessary operational and quality-of-care improvements were in place, and sufficient political and technical support existed to proceed, it was possible to establish low-cost, well-used, and sustainable vasectomy services free of charge. The findings show that careful attention to the development of strong technical competence and an informed choice process resulted in high user satisfaction. Focus-group discussions with men who underwent vasectomy indicate that they had no objection to being served in the context of a women's health center and that they act as opinion leaders who draw an increasing clientele to the service.
Assuntos
Países em Desenvolvimento , Planejamento em Saúde/organização & administração , Saúde Pública , Vasectomia , Adulto , Brasil , Comportamento do Consumidor , Feminino , Humanos , Masculino , Centros de Saúde Materno-Infantil/organização & administração , Garantia da Qualidade dos Cuidados de Saúde/organização & administraçãoRESUMO
PURPOSE: To evaluate the clinical and evolutive aspects of chronic chagasic patients. METHODS: Three hundred chronic chagasic patients, 180 females, with age ranging from 19 to 81 years (55.6 +/- 13.1) were retrospectively studied. Patients were divided according to the following clinical types: indeterminated, cardiac (with the subtypes: arrhythmogenic, dilated and mixed), digestive isolated and digestive plus cardiac involvement. The following variables were analysed: prevalence of each clinical forms, symptoms, electrocardiographic pattern and clinical outcome. RESULTS: At the start of the study, 73 (24.3%) patients were in indetermined type, 106 (35.3%) in cardiac arrhythmogenic, 95 (31.6%) in mixed, 7 (2.3%) in dilated, 16 (5.3%) in digestive plus cardiac type and 3 (1%) in the pure digestive type. The most prevalent symptoms were dyspnea on efforts (57%), palpitations (41.33%) and chest pain (33%). The most frequent electrocardiographic pattern was right bundle branch block plus antero-superior fascicular block, in 30% of the patients. The average follow-up time was 7.8 +/- 6.1 years and the outcome was considered good in 20 patients (6.6%), stable in 214 (71.3%) and bad in 66 (23%). At the end of the follow-up, 9 patients have evaluated from the indeterminated to the cardiac and digestive types, and 19 (17.92%), from the arrhythmogenic to mixed cardiac subtype. The follow-up was lost in 79 patients (26.3%), most of them, probably dead. CONCLUSION: With a mean time of 7.8 years, 12.3% of the patients in the indeterminated type evolved to the cardiac and/or digestive type; right brundle branch block with antero-superior fascicular block was the most prevalent electrocardiographic pattern; the outcome was stable or good in the majority of these patients.
Assuntos
Doença de Chagas/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença de Chagas/complicações , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
O objetivo do presente trabalho é o de avaliar o comportamento de um tipo de prótese rosqueada em artroplastia total do quadril, avaliando-se o comportamento clínico e o radiológico em 171 cirurgias com seguimento mínimo de dois anos em 206 pacientes, operados no período entre abril de 1989 e março de 1992.
Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Pessoa de Meia-Idade , Prótese de Quadril , Idoso de 80 Anos ou mais , Estudo de Avaliação , Seguimentos , Estudos RetrospectivosRESUMO
Os autores analisaram 25 quadris em 19 pacientes portadores de necrose avascular da cabeça femoral que foram tratados pela técnica de descompressao cirúrgica com ou sem a utilizaçäo de enxerto ósseo autólogo, no período entre 1982 e 1992. Foi adotada a classificaçäo de Ficat para o estadiamento dos casos e a técnica operatória utilizada foi a descrita por Phemister e posteriormente a preconizada por Ficat. Os resultados pós-operatórios foram avaliados pelo método de Harris, levando em consideraçäo os parâmetros dor, funçäo, grau de movimentos e ausência de deformidade. Foram obtidos 14 resultados satisfatórios e 11 insatisfatórios, sendo que os melhores resultados encontravam-se nos estágios iniciais de doença. O tempo de seguimento médio dos pacientes foi de 75 meses. Ressalta-se a importância: do diagnóstico precoce, pois foi notada uma relaçäo direta entre o resultado e o estágio em que se encontrava a lesäo; do fato de näo haver diferença no resultado final entre pacientes que utilizaram ou näo enxerto ósseo; e da simplicidade do método empregado, que por tratar-se de procedimento biológico näo invalida procedimentos futuros e consegue prorrogar por prazos significativos a artroplastia total do quadril.
Assuntos
Humanos , Masculino , Feminino , Adulto , Transplante Ósseo , Necrose da Cabeça do Fêmur/cirurgia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Os autores apresentam 36 casos de revisäo de prótese de quadril, com um seguimento médio de 23 meses, com utilizaçäo de enxerto ósseo proveniente de banco de ossos. Avaliam os pacientes no pré e pós-operatório clínica e radiologicamente. Relatam a necessidade de adotar uma classificaçäo de defeitos ósseos proposta por Paprosky, que permite racionalizar o diagnóstico e tratamento. Alertam para a importância de um planejamento cirúrgico adequado (equipe, ambiente, instrumental, variedade de implantes, enxerto, etc.), bem como a realizaçäo do diagnóstico e tratamento cirúrgico precoce, com a finalidade de realizar procedimentos cirúrgicos menos complexos e conseqüentemente aumentar as chances de um bom resultado. Säo discutidos os resultados e as complicaçöes mais freqüentes encontradas em nossa casuística.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Bancos de Ossos , Transplante Ósseo , Prótese de Quadril , Reoperação , Complicações Pós-Operatórias/cirurgia , Seguimentos , QuadrilRESUMO
Os autores apresentam os resultados obtidos pelo Grupo de Quadril do HTO-RJ na utilizaçäo da osteotomia como tratamento da artrose do quadril, dando ênfase à seleçäo de pacientes por critérios clínicos e radiológicos. Demonstram, nos resultados, que näo houve melhora do grau de amplitude articular, dado este de relevância, como critério na avaliaçäo pré-operatória.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Osteoartrite do Quadril/cirurgia , Osteotomia , Placas Ósseas , Estudos RetrospectivosRESUMO
Apresenta-se caso de lesao do nervo mediano em luxacao posterior do cotovelo, que, devido a sua gravidade, deve ser pensada, quando se lida com crianca que sofreu luxacao do cotovelo, principalmente se houver fratura do epicondilo medial associada. E feita revisao do mecanismo, sendo apresentados sinais clinicos e radiologicos e tecnica cirurgica modificada