RESUMO
BACKGROUND: Long periods of ischemia can cause organ injury and dysfunction. The protein degradation occurring in the muscular layer and in the mucosa of the intestinal wall during ischemia may release amino acids into the intestinal lumen or into the circulation. The small intestine, like skeletal muscle, cannot synthesize or degrade tyrosine. Thus, the tyrosine concentration released from the gut mucosa reflects the balance between protein synthesis and degradation. We aimed to determine whether tyrosine can be used as a marker of intestinal injury during ischemia. METHODS: In 19 anesthetized rabbits, an ultrasonic flow probe was placed around the superior mesenteric artery to estimate blood flow. A segment from the ileum was isolated using two multilumen catheters with inflated balloons to create a closed segment for perfusion. Animals were allocated into three groups: a sham group without intervention (group I); a group submitted to superior mesenteric artery ligation only (group II); and a group submitted to 1 h of SMA clamping followed by 1 h of reperfusion (group III). Concentrations of lactate and tyrosine (fluorometry) were determined in the serum and the gut luminal perfusate. RESULTS: Gut luminal perfusate tyrosine concentrations increased significantly in group II (from 10 +/- 8 to 93 +/- 63 mm/mL at 2 h) and were significantly higher than in group I (26 +/- 24 mm/mL) and group III (11 +/- 13 mm/mL) (P < 0.05 for all). CONCLUSION: Tyrosine is released from cells into the lumen during severe intestinal ischemia. Regional measurements of tyrosine levels may be a useful indicator of severe intestinal villus compromise.
Assuntos
Mucosa Intestinal/metabolismo , Intestinos/irrigação sanguínea , Isquemia/metabolismo , Tirosina/metabolismo , Animais , Biomarcadores/metabolismo , Modelos Animais de Doenças , Feminino , Mucosa Intestinal/patologia , Intestinos/patologia , Isquemia/patologia , Lactatos/metabolismo , Masculino , Coelhos , Fluxo Sanguíneo Regional/fisiologia , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/patologiaRESUMO
OBJECTIVE: To assess through high-resolution computed tomography the pulmonary parenchyma of children prematurely born with both very low birth weight and patent ductus arteriosus submitted to medical or surgical treatment that developed bronchopulmonary dysplasia. METHODS: Between December 2006 and January 2007, 14 children prematurely born with a weight less than 1500 g with bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA) were submitted to high-resolution computed tomography (HRCT). All of them underwent surgical closure of the canal divided into two groups: A - medical (n=6) and B - surgical (n=8). The pool of patients comprised 9 baby boys and 5 girls who were 36.5+/-4.3 month-old. The HRCT were analyzed by two independent observers and quantified in each patient. The statistical analyses were assessed using the Mann-Whitney test, and p<0.05 was considered statistically significant. RESULTS: Three patients presented normal tomographies, being two of A group and one of B. In A, the most frequent finding was multifocal ground-glass opacity. In B, multifocal ground-glass opacity, atelectasis, and low attenuation areas with relatively decreased number and caliber of vessels were prevalent (62.5%). There was a statistically significant difference between both groups, with B having higher averages in the intubation times, use of oxygen, and admission. However, as to the number of injuries found on HRCT there was no statistically significant difference (p=0.0787). CONCLUSION: The lately use of HRCT have shown no significant difference between both medical and surgical treatment aiming at to occlude the PDA in pulmonary parenchyma injuries of premature with PDA that developed bronchopulmonary dysplasia.
Assuntos
Displasia Broncopulmonar/diagnóstico por imagem , Permeabilidade do Canal Arterial/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Displasia Broncopulmonar/etiologia , Pré-Escolar , Permeabilidade do Canal Arterial/complicações , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Recém-Nascido de muito Baixo Peso , Masculino , Atelectasia Pulmonar/diagnóstico por imagem , Estudos Retrospectivos , Estatísticas não Paramétricas , Tomografia Computadorizada por Raios XRESUMO
O objetivo deste trabalho foi identificar as causas da interrupção do aleitamento e elaborar programas destinados à prevenção do desmame precoce. A metodologia consistiu na coleta de dados realizada com a mãe até o 3º dia de puerpério, após 40 dias e 12 semanas pós-parto. Foram analisadas 57 pacientes, e a população foi dividida em 2 grupos: grupo das mães cujos RN estavam com aleitamento materno e o outro grupo com demais tipos de alimentos. Verificou-se que a população de risco para o desmame precoce são as mulheres que apresentam estado marital não definido, moradoras em casas maiores que 5 cômodos e que não planejam a gestação. Entre as causas de desmame estão a prematuridade, trabalho profissional e ou estudo. A principal causa (64,7 por cento), porém, são os conceitos inadequados sobre o leite materno. Desta forma é necessária uma maior conscientização do grupo de risco
Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Lactente , Aleitamento Materno , Lactação , Leite Humano , DesmameRESUMO
Os autores relatam um caso de tumor carcinóide avançado de esôfago e estômago caracterizado por dor epigástrica, vômitos e hematêmese. O diagnóstico foi feito pela endoscopia, a qual demonstrou duas lesöes polipóides em esôfago e uma lesäo ulcerada gigante em estômago, sendo confirmado pela anatomia patológica