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INTRODUCTION: Ultrasound measurement of the radial resistance index (RRI) in the anatomical snuffbox has been proposed as a useful method for assessing the systemic vascular resistance index (SVRI). This study aims to establish the correlation between SVRI measured by pulmonary artery catheter (PAC) and RRI. METHODS: A cross-sectional study included all consecutive patients undergoing postoperative (POP) cardiac surgery with hemodynamic monitoring using PAC. Hemodynamic assessment was performed using PAC, and RRI was measured with ultrasound in the anatomical snuffbox. The Pearson correlation test was used to establish the correlation between RRI and SVRI measured using PAC. Hemodynamic behavior concerning RRI with a cutoff point of 1.1 (described to estimate under SVRI) was examined. Additionally, consistency between two evaluators was assessed for RRI using the intraclass correlation coefficient and Bland-Altman analysis. RESULTS: A total of 35 measurements were obtained. The average cardiac index (CI) was 2.73 ± 0.64 L/min/m², and the average SVRI was 1967.47 ± 478.33 dyn·s·m²/cm5. The correlation between RRI and SVRI measured using PAC was 0.37 [95% CI 0.045-0.62]. The average RRI was 0.94 ± 0.11. RRI measurements > 1.1 had a mean SVRI of 2120.79 ± 673.48 dyn·s·m²/cm5, while RRI measurements ≤ 1.1 had a mean SVRI of 1953.1 ± 468.17 dyn·s·m²/cm5 (p = 0.62). The consistency between evaluators showed an intraclass correlation coefficient of 0.88 [95% CI 0.78-0.93], and Bland-Altman analysis illustrated adequate agreement of RRI evaluators. CONCLUSIONS: For patients in cardiac surgery POP, the correlation between the SVRI measured using PAC and the RRI measured in the anatomical snuffbox is low. Using the RRI as a SVRI estimator for patients is not recommended in this clinical scenario.
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OBJECTIVES: This study aimed to evaluate the cost-effectiveness of the triglycerides and glucose index (TyG) versus the homeostatic model assessment for insulin resistance index (HOMA-IR) for diagnosing insulin resistance. METHODS: A cost-effectiveness analysis using a decision tree based on the false-negative and false-positive tests and the true-positive and true-negative tests of both the TyG and HOMA-IR was conducted. Based on the costs and effectiveness of both tests, the average and incremental cost-effectiveness ratios were calculated. Furthermore, one-way sensitivity analysis was conducted regarding sensitivity of both indexes. Using the Monte Carlo simulation with 10 000 iterations, a probabilistic sensitivity analysis that included sensitivity, specificity, and cost of diagnostic tests was conducted. Finally, using the α and ß values obtained from the primary data, the beta distribution was used for estimation of sensitivity and specificity. RESULTS: The cost-effectiveness per test was $1.64 versus $4.26 for TyG and HOMA-IR. The effectiveness of true-positive (0.77 vs 0.74) and true-negative (0.17 vs 0.15) tests was higher for the TyG than HOMA-IR. The cost-effectiveness ratio was lower for the TyG than the HOMA-IR, for both the true-positive ($1.64 vs $4.26) and true-negative ($7.33 vs $20.70) tests. Diagnosing IR using the TyG was 61.5% lower than using the HOMA-IR. CONCLUSIONS: Our findings indicate that the TyG is a high effectiveness and cost-effective test for diagnosing insulin resistance than the HOMA-IR.
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Resistência à Insulina , Humanos , Glucose , Glicemia , Análise de Custo-Efetividade , Triglicerídeos , BiomarcadoresRESUMO
INTRODUCTION: Sepsis is a disease that is still associated with high mortality, in which timely interventions are related to better results. OBJECTIVE: To determine if there is a difference in in-hospital mortality, fluid balances, norepinephrine initiation and recovery time of blood pressure, when comparing the resuscitation of the patient who is admitted to the emergency room in septic shock by applying the ultrasound protocol (USER) versus the standard of care. PATIENTS AND METHODS: This is a prospective, cohort study conducted in the emergency room of a highly complex hospital of patients with septic shock. RESULTS: 83 patients recruited in total. The groups were comparable in demographics, mean baseline blood pressure, disease severity given by the SOFA value, and arterial lactate. A statistically significant difference was documented in the fluid balances at 4 hours, median 1325mL (IQR:451-2455mL) in Group C versus 900mL (IQR:440-1292) in Group U (p=0.048) and at 6 hours, median 1658mL (IQR:610-2925mL) versus 1107mL (IQR:600-1500mL), p=0.026, as well as in the total fluid balance of hospital stay, median 14,564mL (IQR:8660-18,705mL) versus 8660mL (IQR:5309-16,974mL), p=0.049. On the other hand, in the USER Group, the mean blood pressure ≥ 65mmHg was achieved in 97.4% of the patients 4 hours after the start of the protocol versus 50% in Group C (p=<0.001). Mortality with the use of the protocol compared with conventional therapy was (56.4% vs 61.36%, p=0.647). CONCLUSION: The use of the USER protocol in patients with septic shock in the emergency room showed lower fluid balances at 4 and 6 hours, and of the total hospital stay, as well as earlier initiation of norepinephrine and statistically significant faster improvement in blood pressure. Although a statistically significant difference was not found in the days of ICU stay, hospitalization and in-hospital mortality, a trend was observed in the reduction of these parameters.
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This study shows that the non-steroidal anti-inflammatory drug (NSAID) celecoxib and its non-cyclooxygenase-2 (COX2) analogue dimethylcelecoxib (DMC) exert a potent inhibitory effect on the growth of human cervix HeLa multi-cellular tumor spheroids (MCTS) when added either at the beginning ("preventive protocol"; IC50 = 1 ± 0.3 nM for celecoxib and 10 ± 2 nM for DMC) or after spheroid formation ("curative protocol"; IC50 = 7.5 ± 2 µM for celecoxib and 32 ± 10 µM for DMC). These NSAID IC50 values were significantly lower than those attained in bidimensional HeLa cells (IC50 = 55 ± 9 µM celecoxib and 48 ± 2 µM DMC) and bidimensional non-cancer cell cultures (3T3 fibroblasts and MCF-10A mammary gland cells with IC50 from 69 to >100 µM, after 24 h). The copper-based drug casiopeina II-gly showed similar potency against HeLa MCTS. Synergism analysis showed that celecoxib, DMC, and casiopeinaII-gly at sub-IC50 doses increased the potency of cisplatin, paclitaxel, and doxorubicin to hinder HeLa cell proliferation through a significant abolishment of oxidative phosphorylation in bidimensional cultures, with no apparent effect on non-cancer cells (therapeutic index >3.6). Similar results were attained with bidimensional human cervix cancer SiHa and human glioblastoma U373 cell cultures. In HeLa MCTS, celecoxib, DMC and casiopeina II-gly increased cisplatin toxicity by 41-85%. These observations indicated that celecoxib and DMC used as adjuvant therapy in combination with canonical anti-cancer drugs may provide more effective alternatives for cancer treatment.
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INTRODUCTION AND OBJECTIVES: The association between non-alcoholic fatty liver disease and cerebral hemodynamics arises from cardiovascular damage mechanisms such as endothelial dysfunction, arterial wall increased stiffness, high thickness of the intimate index of the internal carotid artery, left ventricular hypertrophy, left diastolic dysfunction, calcification coronary arteries and increased epicardial fat. The multidirectional relationship between systemic inflammation and lipid metabolism constitutes a common and simultaneous mechanism that causes vascular damage. This study aims to provide insight into the relationship between non-alcoholic fatty liver disease and the function of systemic circulation and cerebral circulation using Doppler ultrasound. PATIENTS AND METHODS: Is an observational, cross-sectional, prospective, comparative study conducted at Medica Sur Hospital. Thirty-five patients were selected consecutively. The patients consulted neurological service for various symptoms without severity criteria, such as vertigo, primary headache and balance disturbances. RESULTS: There is a difference in the variables mean of the right MCA PI (pâ¯=â¯0.023), left MCA PI" (pâ¯=â¯0.004), and left VA PI (pâ¯=â¯0.036) between the control and NAFLD groups. The correlation analysis between these variables and the CAP showed a positive correlation of the three variables with the CAP, "right MCA PI" (râ¯=â¯0.384), left MCA PI "(râ¯=â¯0.509) and" left VA PI " (râ¯=â¯0.551). CONCLUSIONS: This study demonstrates a subclinical process of the middle cerebral artery in subjects with NAFLD, which suggests it may be involved in the disease development and points the need to make decisions for this liver manifestation prevention and treatment.
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Artérias Cerebrais/fisiopatologia , Veias Cerebrais/fisiopatologia , Circulação Cerebrovascular/fisiologia , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Adulto , Idoso , Velocidade do Fluxo Sanguíneo/fisiologia , Estudos de Casos e Controles , Artérias Cerebrais/diagnóstico por imagem , Veias Cerebrais/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Estudos Prospectivos , Fluxo Pulsátil/fisiologia , Ultrassonografia Doppler , Resistência Vascular/fisiologiaRESUMO
INTRODUCTION: Surgery for congenital heart disease can generate cerebral perfusion-associated alterations with neurological repercussions. OBJECTIVE: To analyze the relationship of peri-surgical cerebrovascular resistance index (RI) with mediate neurological functions after congenital heart disease surgery. METHOD: Prospective cohort study of 34 neonates in whom basilar artery RI, serum oxygen, carbon dioxide and lactate levels were determined before and after palliative or corrective procedures. We related pre-surgical RI with post-surgical ability to initiate the enteral route or to restore unassisted spontaneous breathing. RESULTS: Three groups were formed: 79 neonates with high RI (> 0.73), 73 with normal RI (0.63 to 0.73) and eight with low RI (< 0.63). In the former group, high RI persisted in the postoperative period, with persistent hyperlactatemia and hypoxia; in 86 %, the enteral route could not be initiated, and neither could assisted ventilation be withdrawn. In the second group, RI remained within normal values. In the third group, although RI, serum lactate and arterial oxygen pressure tended to normalize, 71 % had severe neurological damage. CONCLUSIONS: RI changes were common, although neurological damage appears to occur more commonly when RI remains high, possibly associated with low cerebral blood flow.
INTRODUCCIÓN: La cirugía de cardiopatías congénitas puede generar alteraciones perfusorias cerebrales con repercusión neurológica. OBJETIVO: Analizar la relación del índice de resistencia (IR) vascular cerebral periquirúrgico con funciones neurológicas mediatas posteriores a cirugía de cardiopatía congénita. MÉTODO: Estudio de cohorte prospectivo de 34 neonatos en quienes se determinó IR de la arteria basilar, niveles séricos de oxígeno, dióxido de carbono y lactato, antes y después de procedimientos paliativos o correctivos. Relacionamos el IR prequirúrgico con la capacidad posquirúrgica para iniciar la vía enteral o restablecer la respiración espontánea no asistida. RESULTADOS: Se integraron tres grupos: 79 neonatos con IR alto > 0.73, 73 con IR normal de 0.63 a 0.73 y ocho con IR bajo < 0.63. En los primeros persistió IR elevado en el posquirúrgico, con hiperlactatemia e hipoxia persistentes; en 86 % no se logró iniciar la vía enteral ni retirar la ventilación asistida. En los segundos, el IR se mantuvo en valores normales. En los terceros, si bien el IR, el lactato sérico y la presión arterial de oxígeno tendieron a normalizarse, 71 % presentó daño neurológico grave. CONCLUSIONES: Los cambios en el IR fueron frecuentes, aunque el daño neurológico parece presentarse más cuando el IR se mantiene alto, posiblemente asociado con flujos cerebrales bajos.
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Encéfalo/irrigação sanguínea , Cardiopatias Congênitas/cirurgia , Circulação Cerebrovascular , Humanos , Hiperlactatemia , Hipóxia , Recém-Nascido , Estudos ProspectivosRESUMO
Resumen Introducción: La cirugía de cardiopatías congénitas puede generar alteraciones perfusorias cerebrales con repercusión neurológica. Objetivo: Analizar la relación del índice de resistencia (IR) vascular cerebral periquirúrgico con funciones neurológicas mediatas posteriores a cirugía de cardiopatía congénita. Método: Estudio de cohorte prospectivo de 34 neonatos en quienes se determinó IR de la arteria basilar, niveles séricos de oxígeno, dióxido de carbono y lactato, antes y después de procedimientos paliativos o correctivos. Relacionamos el IR prequirúrgico con la capacidad posquirúrgica para iniciar la vía enteral o restablecer la respiración espontánea no asistida. Resultados: Se integraron tres grupos: 17 neonatos con IR alto > 0.73, cinco con IR normal de 0.63 a 0.73 y seis con IR bajo < 0.63. En los primeros persistió IR alto en el posquirúrgico, con hiperlactatemia e hipoxia persistentes; en 86 % no se logró iniciar la vía enteral ni retirar la ventilación asistida. En los segundos, el IR se mantuvo en valores normales. En los terceros, si bien el IR, el lactato sérico y la presión arterial de oxígeno tendieron a normalizarse, 71 % presentó daño neurológico grave. Conclusiones: Los cambios en el IR fueron frecuentes, aunque el daño neurológico parece presentarse más cuando el IR se mantiene alto, posiblemente asociado a flujos cerebrales bajos.
Abstract Introduction: Surgery for congenital heart disease can generate cerebral perfusion-associated alterations with neurological repercussions. Objective: To analyze the relationship of peri-surgical cerebrovascular resistance index (RI) with mediate neurological functions after congenital heart disease surgery. Method: Prospective cohort study of 34 neonates in whom basilar artery RI, serum oxygen, carbon dioxide and lactate levels were determined before and after palliative or corrective procedures. We related pre-surgical RI with post-surgical ability to initiate the enteral route or to restore unassisted spontaneous breathing. Results: Three groups were formed: 17 neonates with high RI (> 0.73), five with normal RI (0.63-0.73) and six with low RI (< 0.63). In the former group, high RI persisted in the postoperative period, with persistent hyperlactatemia and hypoxia; in 86%, the enteral route could not be initiated, and neither could assisted ventilation be withdrawn. In the second group, IR remained within normal values. In the third group, although RI, serum lactate and arterial oxygen pressure tended to normalize, 71% had severe neurological damage. Conclusions: RI changes were common, although neurological damage appears to occur more commonly when RI remains high, possibly associated with low cerebral blood flow.
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Humanos , Recém-Nascido , Encéfalo/irrigação sanguínea , Cardiopatias Congênitas/cirurgia , Circulação Cerebrovascular , Estudos Prospectivos , Hiperlactatemia , HipóxiaRESUMO
BACKGROUND: Reference values for umbilical artery Doppler indices are used clinically to assess fetal well-being. However, many studies that have produced reference charts have important methodologic limitations, and these result in significant heterogeneity of reported reference ranges. OBJECTIVES: To produce international gestational age-specific centiles for umbilical artery Doppler indices based on longitudinal data and the same rigorous methodology used in the original Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. STUDY DESIGN: In Phase II of the INTERGROWTH-21st Project (the INTERBIO-21st Study), we prospectively continued enrolling pregnant women according to the same protocol from 3 of the original populations in Pelotas (Brazil), Nairobi (Kenya), and Oxford (United Kingdom) that had participated in the Fetal Growth Longitudinal Study. Women with a singleton pregnancy were recruited at <14 weeks' gestation, confirmed by ultrasound measurement of crown-rump length, and then underwent standardized ultrasound every 5±1 weeks until delivery. From 22 weeks of gestation umbilical artery indices (pulsatility index, resistance index, and systolic/diastolic ratio) were measured in a blinded fashion, using identical equipment and a rigorously standardized protocol. Newborn size at birth was assessed using the international INTERGROWTH-21st Standards, and infants had detailed assessment of growth, nutrition, morbidity, and motor development at 1 and 2 years of age. The appropriateness of pooling data from the 3 study sites was assessed using variance component analysis and standardized site differences. Umbilical artery indices were modeled as functions of the gestational age using an exponential, normal distribution with second-degree fractional polynomial smoothing; goodness of fit for the overall models was assessed. RESULTS: Of the women enrolled at the 3 sites, 1629 were eligible for this study; 431 (27%) met the entry criteria for the construction of normative centiles, similar to the proportion seen in the original fetal growth longitudinal study. They contributed a total of 1243 Doppler measures to the analysis; 74% had 3 measures or more. The healthy low-risk status of the population was confirmed by the low rates of preterm birth (4.9%) and preeclampsia (0.7%). There were no neonatal deaths and satisfactory growth, health, and motor development of the infants at 1 and 2 years of age were documented. Only a very small proportion (2.8%-6.5%) of the variance of Doppler indices was due to between-site differences; in addition, standardized site difference estimates were marginally outside this threshold in only 1 of 27 comparisons, and this supported the decision to pool data from the 3 study sites. All 3 Doppler indices decreased with advancing gestational age. The 3rd, 5th 10th, 50th, 90th, 95th, and 97th centiles according to gestational age for each of the 3 indices are provided, as well as equations to allow calculation of any value as a centile and z scores. The mean pulsatility index according to gestational age = 1.02944 + 77.7456*(gestational age)-2 - 0.000004455*gestational age3. CONCLUSION: We present here international gestational age-specific normative centiles for umbilical artery Doppler indices produced by studying healthy, low-risk pregnant women living in environments with minimal constraints on fetal growth. The centiles complement the existing INTERGROWTH-21st Standards for assessment of fetal well-being.
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Velocidade do Fluxo Sanguíneo/fisiologia , Idade Gestacional , Artérias Umbilicais/diagnóstico por imagem , Resistência Vascular/fisiologia , Adulto , Brasil , Desenvolvimento Infantil , Estudos de Coortes , Diástole , Feminino , Desenvolvimento Fetal , Humanos , Lactente , Recém-Nascido , Quênia , Estudos Longitudinais , Masculino , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Valores de Referência , Sístole , Ultrassonografia Doppler em Cores , Ultrassonografia Doppler de Pulso , Ultrassonografia Pré-Natal , Artérias Umbilicais/fisiologia , Reino Unido , Adulto JovemRESUMO
PURPOSE: Among the inheritable forms of impaired sensitivity to thyroid hormone, resistance to thyroid hormone (RTH) due to mutations in the thyroid hormone receptor beta gene (THRB) is the first and best known described defect, revealing a wide phenotypic variability with an incompletely understood physiopathology. The objective of this study was to evaluate two novel mutations in THRB, N331H and L346R, in an attempt to provide a rational understanding of the harmful effects caused by them. METHODS: The mutations of two patients with RTHß were reproduced for analysis of gene transactivation by dual-luciferase reporter assay, and for molecular modeling for crystallography-based structural assessment. Serum measurements of TSH and FT4 were performed to compare the thyrotrophic resistance to thyroid hormone between RTHß patients and controls. RESULTS: Both mutants showed impaired gene transactivation, with greater damage in L346R. Molecular modeling suggested that the damage occurring in N331H is primarily due to reduced strength of the hydrogen bonds that stabilize T3 in its ligand-binding cavity (LBC), whereas in L346R, the damage is more marked and is mainly due to changes in hydrophobicity and molecular volume inside the LBC. Hormonal dosages indicated that the L346R mutant exhibited greater thyrotrophic resistance than N331H. CONCLUSIONS: This study provides a rational understanding of the effects of mutations, indicating deleterious structural changes in the LBC in both THR, and discloses that not only the position of the mutation but, notably, the nature of the amino acid exchange, has a cardinal role in the functional damage of the receptor.
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Receptores beta dos Hormônios Tireóideos , Síndrome da Resistência aos Hormônios Tireóideos , Humanos , Mutação , Receptores beta dos Hormônios Tireóideos/genética , Síndrome da Resistência aos Hormônios Tireóideos/genética , Hormônios TireóideosRESUMO
Twenty-eight pluriparous and non-lactating Santa Inês sheep were synchronized with vaginal sponge and an intramuscular (IM) injection of 37.5 µg of cloprostenol on random days of the estrous cycle (D0); day 6 (D6), at 7:00 am, the devices were removed, and after 24 h (D7), GnRH analog (25 µg of lecirelin) was administrated. Fixed-time artificial insemination (FTAI) with cervical traction by the transcervical route was performed 52 to 58 h after sponge removal. Doppler velocimetry of both uterine arteries was performed on D0, D2, D4, and the morning of D6 (every 48 h), and then every 12 h from D6 to D8 (7:00 a.m. and 7:00 p.m.). We analyzed the peak systolic velocity (PSV), end-diastolic velocity (EVD), time-averaged maximum and mean velocity (TAMAX, TAMEAN), pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (S/D), arterial diameter (AD), and blood flow volume (BFV), with the objective of evaluating the hemodynamic behavior of blood flow velocity parameters of the uterine artery during a short-term progesterone synchronization protocol in ewes. With respect to phases, we noted increases in the means of TAMAX and TAMEAN and decreases of EDV, PI, and RI (P < 0.05). S/D, EDV, TAMEAN, PI, RI, SD, AD, and BFV showed differences between the time of progesterone insertion and the estimated time of ovulation (which was considered the last evaluation) (P < 0.05). The PI and RI values were different when comparing the times of insertion and withdrawal of the progesterone device (PI 2.53-1.54 and RI 0.76-0.68) (P < 0.05). The PI was different with respect to side (P < 0.001), but no side effect was seen in the RI. In conclusion, the two uterine arteries behave differently under the effect of progesterone (intravaginal sponges) and the effect of estradiol during the follicular phase, and estrous phase was responsible for increasing uterine blood flow.
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Cloprostenol/farmacologia , Sincronização do Estro , Hemodinâmica , Luteolíticos/farmacologia , Carneiro Doméstico/fisiologia , Útero/irrigação sanguínea , Animais , Feminino , Inseminação Artificial/veterinária , Oligopeptídeos/administração & dosagem , Ovulação/efeitos dos fármacos , Progesterona , Artéria UterinaRESUMO
Epidemiological studies indicate an inverse association of coffee consumption with risk of type 2 diabetes mellitus. However, studies to determine the clinical effects of coffee consumption on the glucose metabolism biomarkers remain uncertain. The aim of this systematic review was to evaluate the effects of coffee consumption on glucose metabolism. A search of electronic databases (PubMed and Web of Science) was performed identifying studies published until September 2017. Eight clinical trials (nâ¯=â¯247 subjects) were identified for analyses. Participants and studies characteristics, main findings, and study quality (Jadad Score) were reported. Short-term (1-3â¯h) and long-term (2-16 weeks) studies were summarized separately. Short-term studies showed that consumption of caffeinated coffee may increase the area under the curve for glucose response, while for long-term studies, caffeinated coffee may improve the glycaemic metabolism by reducing the glucose curve and increasing the insulin response. The findings suggest that consumption of caffeinated coffee may lead to unfavourable acute effects; however, an improvement on glucose metabolism was found on long-term follow-up.
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Examining feto-maternal blood flow is extremely important for accurate prenatal control and predicting adverse conditions during puerperium. We aimed to analyze blood flow of uterine artery (UA) and umbilical artery (UMA) from and subsequent to mid-gestation, lambing and postpartum of 15 ewes, subjected to lambing induction with aglepristone. Hemodynamic variables, diameter and blood flow of UA and UMA were determined by Doppler and B-mode ultrasonography at 60, 90 and 120 days of pregnancy, at 12 h before, 12 h after first aglepristone injection and 12 h after induction and days 1, 3, 5, 7, 15 and 30 after lambing. The UMA peak systolic:diastolic velocity (S/D), resistance index (RI) and pulsatility index (PI) decreased from mid-pregnancy until 120 d, whereas peak systolic velocity (PSV), end diastolic velocity (EDV) and time average maximum velocity (TAMAX) increased towards 120 d. The UMA RI additionally decreased at 12 h after lambing induction. The UMA diameter and volume increased from mid-gestation until 12 h before lambing induction. UA PSV and TAMAX increased from 60 until 90 days of pregnancy, while EDV, PSV and TAMAX decreased soon after parturition, with a further reduction at 7 days. The UA diameter and volume decreased during postpartum, stabilizing by 15 days after parturition. In conclusion, pregnancy is marked by progressive increase in uterine and umbilical blood flow, while lambing acutely diminishes umbilical vascular resistance, suggesting lack of progesterone influence on vasodilation. Conversely, puerperium is characterized by reduction in uterine blood supply mostly within the first 2 weeks of postpartum in sheep.
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Hemodinâmica , Parto/fisiologia , Período Pós-Parto/fisiologia , Ovinos/fisiologia , Artérias Umbilicais/irrigação sanguínea , Artéria Uterina/fisiologia , Animais , Animais Recém-Nascidos , Velocidade do Fluxo Sanguíneo , Feminino , Hemodinâmica/fisiologia , Gravidez , Fluxo Sanguíneo Regional/fisiologia , Ultrassonografia Pré-Natal/veterinária , Artérias Umbilicais/diagnóstico por imagem , Artérias Umbilicais/fisiologia , Artéria Uterina/diagnóstico por imagemRESUMO
Canine visceral leishmaniasis frequently causes glomerulonephritis and tubulointerstitial nephritis, nephropathies for which diagnosis has been limited by the low sensitivity of traditional tests. The aim of this study was to evaluate serum cystatin C and urinary gamma-glutamyltransferase (uGGT) levels and the urinary GGT/urinary creatinine ratio (uGGT/uCR) and to measure the renal arterial resistive index (RARI) in dogs with leishmaniasis with varying degrees of renal injury based on the urine protein: creatinine ratio (UP/C) and serum creatinine (SCr) level. We tested 59 untreated adult dogs of both sexes and undefined breeds naturally infected with Leishmania infantum. The dogs were grouped into four groups based on UP/C and SCr level: group 1 (n = 15), dogs with SCr levels < 1.4 mg/dL and UP/C < 0.5; group 2 (n = 13), dogs with SCr levels < 1.4 mg/dL and UP/C of 0.5-1.0; group 3 (n = 16), dogs with SCr levels < 1.4 and UP/C > 1.0; and group 4 (n = 15), dogs with SCr levels > 1.4. A fifth group of healthy dogs (n = 10) was the control. uGGT concentrations and uGGT/uCR were higher in dogs with proteinuria and SCr < 1.4 mg/dL, whereas the serum cystatin C concentrations and RARI were higher only in dogs with SCr levels > 1.4. In conclusion, uGGT and uGGT/uCR may be useful tools for early detection and assessment of renal lesions associated with leishmaniasis; however, cystatin C is useful for monitoring the progression of kidney disease when measured sequentially.
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Creatinina/urina , Cistatina C/sangue , Doenças do Cão/diagnóstico , Glomerulonefrite/diagnóstico , Nefropatias/veterinária , Leishmaniose Visceral/patologia , Nefrite Intersticial/diagnóstico , Artéria Renal/patologia , gama-Glutamiltransferase/urina , Animais , Biomarcadores/urina , Creatinina/sangue , Progressão da Doença , Doenças do Cão/parasitologia , Cães , Feminino , Glomerulonefrite/parasitologia , Glomerulonefrite/veterinária , Rim/parasitologia , Nefropatias/diagnóstico , Nefropatias/parasitologia , Testes de Função Renal , Leishmania infantum/isolamento & purificação , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/veterinária , Masculino , Nefrite Intersticial/parasitologia , Nefrite Intersticial/veterinária , SoroRESUMO
With devastating increase in population there is a great necessity to increase crop productivity of staple crops but the productivity is greatly affected by various abiotic stress factors such as drought, salinity. An attempt has been made a brief account on abiotic stress resistance of major cereal crops viz. In spite of good successes obtained on physiological and use molecular biology, the benefits of this high cost technology are beyond the reach of developing countries. This review discusses several morphological, anatomical, physiological, biochemical and molecular mechanisms of major cereal crops related to the adaptation of these crop to abiotic stress factors. It discusses the effect of abiotic stresses on physiological processes such as flowering, grain filling and maturation and plant metabolisms viz. photosynthesis, enzyme activity, mineral nutrition, and respiration. Though significant progress has been attained on the physiological, biochemical basis of resistance to abiotic stress factors, very little progress has been achieved to increase productivity under sustainable agriculture. Therefore, there is a great necessity of inter-disciplinary research to address this issue and to evolve efficient technology and its transfer to the farmers' fields.
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Grão Comestível/fisiologia , Adaptação Fisiológica , Brassinosteroides , Produtos Agrícolas , Grão Comestível/classificação , Espécies Reativas de Oxigênio/metabolismoRESUMO
The present study aimed to examine the impact of maternal nutritional plane on umbilical hemodynamics. E wes (n = 15) were ass igned to 1 of 3 dietary treatments [ control (CON; 100% of N RC requirements), restricted (RES; 60% of CON) or overfed ( OVR ; 140% of CON) ] beginning on day 40 of gestation . Umbilical artery hemodynamics, fetal growth and placentome growth were measured on da y s 40, 45, 52, 80, 94 and 108 of gestation by Doppler ultrasonography . The percentage change in umbilical artery pulsatility and resistance ind ices remained steady through day 80 of gestation, and then decreased (P 0. 05 ) on day s 80 and 94 of gestation, and then decreased (P < 0.01) by day 108 of gestation. Maternal p lane of nutrition can impact umbilical resistance indices, and ultimately may impact blood flow to the fetus.
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Animais , Artéria Umbilical Única/sangue , Ciências da Nutrição Animal , Hemodinâmica/fisiologia , Ovinos/classificação , Ultrassonografia DopplerRESUMO
The present study aimed to examine the impact of maternal nutritional plane on umbilical hemodynamics. E wes (n = 15) were ass igned to 1 of 3 dietary treatments [ control (CON; 100% of N RC requirements), restricted (RES; 60% of CON) or overfed ( OVR ; 140% of CON) ] beginning on day 40 of gestation . Umbilical artery hemodynamics, fetal growth and placentome growth were measured on da y s 40, 45, 52, 80, 94 and 108 of gestation by Doppler ultrasonography . The percentage change in umbilical artery pulsatility and resistance ind ices remained steady through day 80 of gestation, and then decreased (P < 0. 03 ) by day 108 of gestation . Moreover , p lane of nutrition affected (P < 0. 03 ) the percentage change in pulsatility index from day 40 , with RES ewes having a greater (P < 0.03 ) change compared to CON ( 16. 7 ± 7.5 vs . - 15.6 ± 7.5 %) , with OVR being intermediate ( 3.2 ± 7.5 %). Fetal biparietal and abdominal diameter s increased (P < 0.01) throughout gestation, and f etal heart rate decreased (P < 0.01) from day 52 to 108 of gestation. Placentome diameter increased (P < 0.01) through day 80 of gestation, was similar (P > 0. 05 ) on day s 80 and 94 of gestation, and then decreased (P < 0.01) by day 108 of gestation. Maternal p lane of nutrition can impact umbilical resistance indices, and ultimately may impact blood flow to the fetus.(AU)
Assuntos
Animais , Ciências da Nutrição Animal , Hemodinâmica/fisiologia , Artéria Umbilical Única/sangue , Ovinos/classificação , Ultrassonografia DopplerRESUMO
OBJETIVO: Analisar o valor do diagnóstico precoce de alterações hemodinâmicas em hemorragias e eventos hipóxico-isquêmicos pela avaliação de imagens e mensuração do índice de resistência por meio da ultrassonografia craniana com Doppler em neonatos prematuros de muito baixo peso. MATERIAIS E MÉTODOS: Cinquenta neonatos prematuros de muito baixo peso foram submetidos a ultrassonografia craniana com Doppler com a técnica transfontanela anterior e transtemporal sequenciais. RESULTADOS: Foram detectadas alterações cerebrais em 32 por cento dos prematuros, sendo 22 por cento com hemorragia intracraniana, 8 por cento com leucomalácia periventricular e 2 por cento com toxoplasmose. Dentre os 34 casos (68 por cento), do total de neonatos, nos quais não foram detectadas lesões cerebrais pela ultrassonografia craniana, 18 (53 por cento) apresentaram alterações no índice de resistência. O índice de resistência variou conforme a época do exame. CONCLUSÃO: Existe correlação entre a presença de alterações na hemodinâmica cerebral e subsequente desenvolvimento de hemorragias e lesões hipóxico-isquêmicas, pela mensuração do índice de resistência. Alterações do índice de resistência, embora não preditoras de morte, estão relacionadas com a gravidade do quadro clínico em neonatos prematuros de muito baixo peso.
OBJECTIVE: The present study was aimed at analyzing the value of the early diagnosis of hemodynamic changes in hemorrhages and hypoxic-ischemic events in premature, very-low-birth-weight neonates through the evaluation of images and resistance index measurement by means of transcranial Doppler ultrasonography. MATERIALS AND METHODS: Fifty premature, very-low-birth-weight neonates were submitted to transcranial Doppler ultrasonography with sequential transfontanellar and transtemporal techniques. RESULTS: Cerebral abnormalities were detected in 32 percent of the neonates (22 percent with intracranial hemorrhage, 8 percent with periventricular leukomalacia, and 2 percent with toxoplasmosis). Among the 34 cases (68 percent) of neonates in whom no brain lesion was detected at transcranial Doppler ultrasonography, 18 (53 percent) presented changes in the resistance index. Such resistance index varied according to the time of the examination. CONCLUSION: There is a correlation between the presence of cerebral hemodynamic changes demonstrated by resistance index measurements and the subsequent development of hemorrhages and hypoxic-ischemic lesions. Although not being a death predictor, changes in the resistance index are associated with the severity of the clinical conditions in preterm, very-low-birth-weight neonates.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Hemodinâmica , Hemorragia/diagnóstico , Isquemia , Recém-Nascido Prematuro/fisiologia , Ultrassonografia Doppler TranscranianaRESUMO
OBJETIVO: O objetivo deste estudo foi avaliar o significado do Doppler espectral por meio da obtenção do índice de resistência vascular na diferenciação entre lesões mamárias benignas e malignas. MATERIAIS E MÉTODOS: Dezenove lesões malignas e 18 benignas, diagnosticadas por estudo histológico, foram submetidas previamente a análise de sua vascularização por meio do Doppler espectral para se obter o índice de resistência vascular. RESULTADOS: Observou-se diferença estatisticamente significante (p < 0,001) entre os valores médios do índice de resistência para os resultados benigno e maligno (0,62x 0,80, respectivamente), em nódulos maiores que 1 cm. Um índice de resistência 0,69 foi altamente associado a lesões malignas, com sensibilidade de 84,2 por cento, especificidade de 88,9 por cento, taxa de falso-positivo de 11,1 por cento e taxa de falso-negativo de 15,8 por cento. CONCLUSÃO: A análise do índice de resistência vascular pode fornecer grande auxílio na avaliação das lesões nodulares da mama maiores que 1 cm, em conjunto com as informações obtidas por meio da escala de cinzas, com elevada sensibilidade e especificidade.
OBJECTIVE: The present study was aimed at evaluating the role played by spectral Doppler as a method to measure the vascular resistance index in the differentiation between benign and malignant breast lesions. MATERIALS AND METHODS: Nineteen malignant and 18 benign lesions histologically diagnosed had their vascularization previously analyzed through the resistance index. RESULTS: A statistically significant difference (p < 0.001) was observed between the mean values of resistance index for benign and malignant lesions (respectively 0.62x 0.80) in nodular breast lesions greater than 1 cm. A resistance index 0.69 was highly associated with malignant lesions, with 84.2 percent sensitivity, 88.9 percent specificity, false-positive rate of 11.1 percent, and false-negative rate of 15.8 percent. CONCLUSION: The analysis of vascular resistance index combined with findings on grayscale sonographic images can be of great assistance in the assessment of nodular breast lesions greater than 1 cm, with high sensitivity and specificity.