RESUMO
INTRODUCTION: Portal and mesenteric venous thrombosis is a rare but potentially serious complication after laparoscopic sleeve gastrectomy. There are no consistent studies that prove the safety and effectiveness of oral anticoagulant thromboprophylaxis with rivaroxaban after laparoscopic sleeve gastrectomy. The objective was to evaluate the effect of rivaroxaban on the frequency of portal and mesenteric venous thrombosis and its safety profile after laparoscopic sleeve gastrectomy. MATERIALS AND METHODS: This retrospective analysis of prospectively collected data includes all laparoscopic sleeve gastrectomies performed by a single surgeon at Pontificia Universidad Católica de Chile Hospital between January 2009 and June 2019. All patients received low molecular weight heparin thromboprophylaxis during the whole hospital stay. Between July 2012 and June 2019, patients received additional post-discharge thromboprophylaxis with rivaroxaban. Patient demographics, impaired renal, post-surgical portal and mesenteric venous thrombosis, and bleeding episodes were registered. RESULTS: A total of 516 patients were identified; 95 patients were excluded. Results for 421 patients were analysed: 198 received only intrahospital thromboprophylaxis (group 1) and 223 received additional post-discharge thromboprophylaxis with rivaroxaban (group 2). There was no statistically significant difference between the two groups concerning age, sex and body mass index. In group 1, four cases of portal and mesenteric venous thrombosis were registered and no cases were reported in group 2 (p < 0.05). All cases occurred before 30 days after surgery. No bleeding episodes and no adverse reactions were detected in group 2. CONCLUSIONS: Thromboprophylaxis during the whole hospital stay (two to three days), followed by rivaroxaban 10mg once daily for 10 days after discharge (completing in total 13-14 days of prophylaxis), could reduce cases of post-surgical portal and mesenteric venous thrombosis without an increase in bleeding complications.
Assuntos
Inibidores do Fator Xa/uso terapêutico , Gastrectomia/efeitos adversos , Laparoscopia/efeitos adversos , Isquemia Mesentérica/prevenção & controle , Rivaroxabana/uso terapêutico , Adulto , Quimioprevenção/métodos , Feminino , Gastrectomia/métodos , Humanos , Laparoscopia/métodos , Masculino , Estudos RetrospectivosRESUMO
Abstract Purpose: To investigate the role of atenolol in the gene expression of caspase 1 (Casp1) and Bcl2L1 on vascular endothelium of rat intestine after ischemia and reperfusion (IR). Methods: Eighteen adult male Wistar rats were randomly divided into 3 groups (n=6): SG (Sham group): no clamping of the superior mesenteric artery; IRG: IR plus saline group: IRG+At: IR plus Atenolol group. Rats from IRG and IRG+At were subjected to 60 min of intestinal ischemia and 120 min of reperfusion. Atenolol (2mg/kg) or saline were injected in the femoral vein 5 min before ischemia, 5 min and 55 min after reperfusion. Thereafter, intestinal segments were appropriately removed and processed for Endothelial Cell Biology Rat RT2 Profiler PCR Array. Results: the anti-apoptotic Bcl2L1 gene expression was significantly down-regulated (-1.10) in the IRG and significantly up-regulated in the IRG+At (+14.15). Meanwhile, despite Casp1 gene expression was upregulated in both groups, it was significantly higher in the IRG (+35.06) than the IRG+At (+6.68). Conclusions: Atenolol presents antiapoptotic effects on rat intestine subjected to IR partly by the up-regulation of the anti-apoptotic Bcl2L1 gene expression. Moreover, atenolol can mitigate the pro-apoptotic and pro-inflammatory effects of Casp1 gene on rat intestine after IR.
Assuntos
Animais , Masculino , Atenolol/farmacologia , Traumatismo por Reperfusão/prevenção & controle , Expressão Gênica/efeitos dos fármacos , Substâncias Protetoras/farmacologia , Caspase 1/efeitos dos fármacos , Proteína bcl-X/efeitos dos fármacos , Intestino Delgado/irrigação sanguínea , Fatores de Tempo , Endotélio Vascular , Distribuição Aleatória , Regulação para Baixo/efeitos dos fármacos , Regulação para Cima/efeitos dos fármacos , Reação em Cadeia da Polimerase , Reprodutibilidade dos Testes , Resultado do Tratamento , Ratos Wistar , Artéria Mesentérica Superior , Apoptose/efeitos dos fármacos , Constrição , Citoproteção/efeitos dos fármacos , Caspase 1/genética , Proteína bcl-X/genética , Isquemia Mesentérica/prevenção & controleRESUMO
Abstract Purpose: To investigate the gene expression related to inflammation on mice subjected to intestinal ischemia and reperfusion (I/R) and treated with ischemic preconditioning (IPC). Methods: Thirty rats (EPM-Wistar), distributed in five groups of six animals each, were underwent anesthesia and laparotomy. The ischemia time was standardized in 60 minutes and the reperfusion time 120 minutes. IPC was standardized in 5 minutes of ischemia followed by 10 minutes of reperfusion accomplished before I/R. The control group was submitted only to anesthesia and laparotomy. The other groups were submitted to ischemia, I/R, ischemia + IPC and I/R + IPC. It was collected a small intestine sample to analyses by Quantitative Polymerase Chain Reaction in real Time (RT-qPCR) and histological analyses. It was studied 27 genes. Results: The groups that received IPC presented downregulation of genes, observed in of genes in IPC+ischemia group and IPC+I/R group. Data analysis by clusters showed upregulation in I/R group, however in IPC groups occurred downregulation of genes related to inflammation. Conclusion: The ischemia/reperfusion promoted upregulation of genes related to inflammation, while ischemic preconditioning promoted downregulation of these genes.
Assuntos
Animais , Masculino , Traumatismo por Reperfusão/prevenção & controle , Expressão Gênica/fisiologia , Precondicionamento Isquêmico/métodos , Inflamação/prevenção & controle , Intestino Delgado/irrigação sanguínea , Valores de Referência , Fatores de Tempo , Traumatismo por Reperfusão/genética , Regulação para Baixo/fisiologia , Regulação para Cima/fisiologia , Reprodutibilidade dos Testes , Resultado do Tratamento , Ratos Wistar , Reação em Cadeia da Polimerase em Tempo Real , Isquemia Mesentérica/genética , Isquemia Mesentérica/prevenção & controle , Inflamação/genéticaRESUMO
OBJECTIVE: In surgical aortic repair or cardiac surgery with aorta occlusion, the occurrence of mesenteric ischemia and bowel injury has been associated with higher short-term mortality. The vascular protection of estrogens has been investigated and is mainly mediated by increasing the availability of nitric oxide (NO). Therefore, this study investigated the role of 17ß-estradiol on visceral ischemia-reperfusion (I/R) injury after descending aorta occlusion in male rats. METHODS: Mesenteric ischemia was induced in male Wistar rats by placing a 2F Fogarty arterial embolectomy catheter (Edwards Lifesciences, Irvine, Calif) in the descending aorta, which remained occluded for 15 minutes, followed by reperfusion for up to 2 hours. Rats were divided into four groups: (1) rats that underwent surgical manipulation only (sham, n = 22); (2) rats that underwent I/R injury (n = 22); (3) rats treated with intravenous 17ß-estradiol (280 µg/kg) 30 minutes before I/R (n = 22); (4) or at the beginning of reperfusion (n = 22). Intestinal histopathologic changes were evaluated by histomorphometry. Mesenteric microcirculatory alterations were assessed by laser Doppler flowmetry and intravital microscopy technique. Protein expression of intercellular adhesion molecule-1, P-selectin, endothelial NO synthase (eNOS), and endothelin-1 was evaluated by immunohistochemistry; in addition, eNOS and endothelin-1 gene expressions were quantified by real-time polymerase chain reaction. Serum cytokines were measured by enzyme-linked immunosorbent assay. RESULTS: Relative to the sham group, the I/R group exhibited a highly pronounced loss of intestine mucosal thickness, a reduction in mesenteric blood flow (P = .0203), increased migrated leukocytes (P < .05), and high mortality rate (35%). Treatment with 17ß-estradiol before aorta occlusion preserved intestine mucosal thickness (P = .0437) and mesenteric blood flow (P = .0251), reduced the number of migrated leukocytes (P < .05), and prevented any fatal occurrence. Furthermore, 17ß-estradiol downregulated the expression of intercellular adhesion molecule-1 (P = .0001) and P-selectin (P < .0001) on the endothelium and increased the protein expression of eNOS (P < .0001). The gene expressions of eNOS and endothelin-1 did not differ between the groups. CONCLUSIONS: The prophylactic treatment with 17ß-estradiol showed better overall repercussions and was able to prevent any fatal occurrence, increase eNOS expression, thus preserving mesenteric perfusion and intestinal integrity, and reduce inflammation.
Assuntos
Aorta/fisiopatologia , Oclusão com Balão/efeitos adversos , Estradiol/farmacologia , Íleo/irrigação sanguínea , Íleo/efeitos dos fármacos , Isquemia Mesentérica/prevenção & controle , Traumatismo por Reperfusão/prevenção & controle , Circulação Esplâncnica/efeitos dos fármacos , Animais , Modelos Animais de Doenças , Endotelina-1/metabolismo , Íleo/metabolismo , Íleo/patologia , Molécula 1 de Adesão Intercelular/metabolismo , Masculino , Isquemia Mesentérica/etiologia , Isquemia Mesentérica/metabolismo , Isquemia Mesentérica/fisiopatologia , Óxido Nítrico Sintase Tipo III/metabolismo , Selectina-P/metabolismo , Ratos Wistar , Traumatismo por Reperfusão/etiologia , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/fisiopatologia , Transdução de Sinais/efeitos dos fármacos , Fatores de TempoRESUMO
PURPOSE: To investigate the role of atenolol in the gene expression of caspase 1 (Casp1) and Bcl2L1 on vascular endothelium of rat intestine after ischemia and reperfusion (IR). METHODS: Eighteen adult male Wistar rats were randomly divided into 3 groups (n=6): SG (Sham group): no clamping of the superior mesenteric artery; IRG: IR plus saline group: IRG+At: IR plus Atenolol group. Rats from IRG and IRG+At were subjected to 60 min of intestinal ischemia and 120 min of reperfusion. Atenolol (2mg/kg) or saline were injected in the femoral vein 5 min before ischemia, 5 min and 55 min after reperfusion. Thereafter, intestinal segments were appropriately removed and processed for Endothelial Cell Biology Rat RT2 Profiler PCR Array. RESULTS: the anti-apoptotic Bcl2L1 gene expression was significantly down-regulated (-1.10) in the IRG and significantly up-regulated in the IRG+At (+14.15). Meanwhile, despite Casp1 gene expression was upregulated in both groups, it was significantly higher in the IRG (+35.06) than the IRG+At (+6.68). CONCLUSIONS: Atenolol presents antiapoptotic effects on rat intestine subjected to IR partly by the up-regulation of the anti-apoptotic Bcl2L1 gene expression. Moreover, atenolol can mitigate the pro-apoptotic and pro-inflammatory effects of Casp1 gene on rat intestine after IR.
Assuntos
Atenolol/farmacologia , Caspase 1/efeitos dos fármacos , Expressão Gênica/efeitos dos fármacos , Intestino Delgado/irrigação sanguínea , Substâncias Protetoras/farmacologia , Traumatismo por Reperfusão/prevenção & controle , Proteína bcl-X/efeitos dos fármacos , Animais , Apoptose/efeitos dos fármacos , Caspase 1/genética , Constrição , Citoproteção/efeitos dos fármacos , Regulação para Baixo/efeitos dos fármacos , Endotélio Vascular , Masculino , Artéria Mesentérica Superior , Isquemia Mesentérica/prevenção & controle , Reação em Cadeia da Polimerase , Distribuição Aleatória , Ratos Wistar , Reprodutibilidade dos Testes , Fatores de Tempo , Resultado do Tratamento , Regulação para Cima/efeitos dos fármacos , Proteína bcl-X/genéticaRESUMO
PURPOSE: To investigate the gene expression related to inflammation on mice subjected to intestinal ischemia and reperfusion (I/R) and treated with ischemic preconditioning (IPC). METHODS: Thirty rats (EPM-Wistar), distributed in five groups of six animals each, were underwent anesthesia and laparotomy. The ischemia time was standardized in 60 minutes and the reperfusion time 120 minutes. IPC was standardized in 5 minutes of ischemia followed by 10 minutes of reperfusion accomplished before I/R. The control group was submitted only to anesthesia and laparotomy. The other groups were submitted to ischemia, I/R, ischemia + IPC and I/R + IPC. It was collected a small intestine sample to analyses by Quantitative Polymerase Chain Reaction in real Time (RT-qPCR) and histological analyses. It was studied 27 genes. RESULTS: The groups that received IPC presented downregulation of genes, observed in of genes in IPC+ischemia group and IPC+I/R group. Data analysis by clusters showed upregulation in I/R group, however in IPC groups occurred downregulation of genes related to inflammation. CONCLUSION: The ischemia/reperfusion promoted upregulation of genes related to inflammation, while ischemic preconditioning promoted downregulation of these genes.
Assuntos
Expressão Gênica/fisiologia , Inflamação/prevenção & controle , Intestino Delgado/irrigação sanguínea , Precondicionamento Isquêmico/métodos , Traumatismo por Reperfusão/prevenção & controle , Animais , Regulação para Baixo/fisiologia , Inflamação/genética , Masculino , Isquemia Mesentérica/genética , Isquemia Mesentérica/prevenção & controle , Ratos Wistar , Reação em Cadeia da Polimerase em Tempo Real , Valores de Referência , Traumatismo por Reperfusão/genética , Reprodutibilidade dos Testes , Fatores de Tempo , Resultado do Tratamento , Regulação para Cima/fisiologiaRESUMO
Background: Mesenteric ischemia is a challenging diagnosis. Delay in diagnosis can lead to extent bowel necrosis and poor outcomes. Ischemia and reperfusion syndrome plays an important role in this scenario. Aim: To access effects of different post-conditioning cycles on mesenteric ischemia-reperfusion syndrome. Method: Twenty-five rats were assigned into five groups: Sham, used to establish normal parameters; control group, submitted to mesenteric ischemia for 30 min; in groups GP3, GP1 and GP30, ischemia was followed by post-conditioning protocol, which consisted of 1 cycle of 3 min (GP3), 3 cycles of 1 min (GP1) or 6 cycles of 30 s (GP30), respectively. Ileum samples were harvested after one hour of reperfusion. Intestinal mucosal injury was evaluated through histopathological analysis. Results: The average of mesenteric injury degree was 0 in the sham group, 3.6 in the control group, 3.4 in GP3, 3.2 in GP1, and 3.0 in GP30; villous length average was 161.59 in sham group, 136.27 in control group, 135.89 in GP3, 129.46 in GP1, and 135.18 in GP30. Was found significant difference between sham and other groups (p<0.05); however, there was no difference among post-conditioning groups. Conclusion: Post-conditioning adopted protocols were not able to protect intestinal mucosa integrity after mesenteric ischemia and short term reperfusion.
Racional: O desfecho satisfatório na abordagem cirúrgica da obesidade deve contemplar, além da perda de peso, alteração significativa nas comorbidades preexistentes e na qualidade de vida dos pacientes. Objetivo: Avaliar a qualidade de vida no pós-operatório tardio de pacientes submetidos à cirurgia de gastrectomia vertical por videolaparoscopia. Métodos: Foi aplicado o questionário "Bariatric Analysis and Reporting Outcome System" (BAROS) em pacientes submetidos à gastrectomia vertical por videolaparoscopia. Resultados: Foram avaliados 47 pacientes, entre 21 e 60 anos de idade. O IMC médio antes da operação era 43,06±5,87 kg/m². A média percentual de redução do excesso de peso após foi de 85,46±23,6%. A pontuação obtida pelos pacientes no questionário sobre a melhora na qualidade de vida evidenciou resultado excelente (36,17%), ótimo (40,43%), bom (21,28%) e razoável (2,13%). Houve melhora clínica após a operação em todas as comorbidades investigadas. Conclusão: A perda de peso foi fundamental para a melhoria na qualidade de vida e proporcionou resolução ou a melhora clínica em todas as comorbidades investigadas.
Assuntos
Pós-Condicionamento Isquêmico/métodos , Isquemia Mesentérica/prevenção & controle , Mesentério/irrigação sanguínea , Traumatismo por Reperfusão/prevenção & controle , Reperfusão/métodos , Animais , Protocolos Clínicos , Masculino , Ratos , Ratos Wistar , Fatores de TempoRESUMO
ABSTRACT Background: Mesenteric ischemia is a challenging diagnosis. Delay in diagnosis can lead to extent bowel necrosis and poor outcomes. Ischemia and reperfusion syndrome plays an important role in this scenario. Aim: To access effects of different post-conditioning cycles on mesenteric ischemia-reperfusion syndrome. Method: Twenty-five rats were assigned into five groups: Sham, used to establish normal parameters; control group, submitted to mesenteric ischemia for 30 min; in groups GP3, GP1 and GP30, ischemia was followed by post-conditioning protocol, which consisted of 1 cycle of 3 min (GP3), 3 cycles of 1 min (GP1) or 6 cycles of 30 s (GP30), respectively. Ileum samples were harvested after one hour of reperfusion. Intestinal mucosal injury was evaluated through histopathological analysis. Results: The average of mesenteric injury degree was 0 in the sham group, 3.6 in the control group, 3.4 in GP3, 3.2 in GP1, and 3.0 in GP30; villous length average was 161.59 in sham group, 136.27 in control group, 135.89 in GP3, 129.46 in GP1, and 135.18 in GP30. Was found significant difference between sham and other groups (p<0.05); however, there was no difference among post-conditioning groups. Conclusion: Post-conditioning adopted protocols were not able to protect intestinal mucosa integrity after mesenteric ischemia and short term reperfusion.
RESUMO Racional: O desfecho satisfatório na abordagem cirúrgica da obesidade deve contemplar, além da perda de peso, alteração significativa nas comorbidades preexistentes e na qualidade de vida dos pacientes. Objetivo: Avaliar a qualidade de vida no pós-operatório tardio de pacientes submetidos à cirurgia de gastrectomia vertical por videolaparoscopia. Métodos: Foi aplicado o questionário "Bariatric Analysis and Reporting Outcome System" (BAROS) em pacientes submetidos à gastrectomia vertical por videolaparoscopia. Resultados: Foram avaliados 47 pacientes, entre 21 e 60 anos de idade. O IMC médio antes da operação era 43,06±5,87 kg/m². A média percentual de redução do excesso de peso após foi de 85,46±23,6%. A pontuação obtida pelos pacientes no questionário sobre a melhora na qualidade de vida evidenciou resultado excelente (36,17%), ótimo (40,43%), bom (21,28%) e razoável (2,13%). Houve melhora clínica após a operação em todas as comorbidades investigadas. Conclusão: A perda de peso foi fundamental para a melhoria na qualidade de vida e proporcionou resolução ou a melhora clínica em todas as comorbidades investigadas.
Assuntos
Animais , Masculino , Ratos , Reperfusão/métodos , Traumatismo por Reperfusão/prevenção & controle , Pós-Condicionamento Isquêmico/métodos , Isquemia Mesentérica/prevenção & controle , Mesentério/irrigação sanguínea , Fatores de Tempo , Protocolos Clínicos , Ratos WistarRESUMO
ABSTRACT Recent advances in drug delivery systems have aimed to achieve better patient compliance. One of these advances is the formulation of orally disintegrating tablets (ODTs) that dissolve instantaneously, releasing drugs within a few seconds without the need of water. The main objective of this paper was to prepare and develop ODTs of clopidogrel. The ODTs were prepared by direct compression. The effect of three superdisintegrants, namely crospovidone, croscarmellose sodium, and sodium starch glycolate, using three different disintegration times on the dissolution rate was investigated. The prepared tablets were evaluated for hardness, friability, disintegration time and in vitro drug release. Furthermore, the interaction of clopidogrel with the formulation excipients was studied using differential scanning calorimetry (DSC). DSC studies revealed that there were no interactions between the drug and the excipients used. All tablets had hardness values in the range 4.0-5.2 kp and friability lower than 1%. The weight and drug content uniformity of all formulations was within official limits according to BP. In vitro drug release studies of the ODTs showed that more than 90% of the drug was released within ten minutes. A palatability test in human volunteers showed acceptable taste and mouth feel. Thus, the obtained results conclusively demonstrated successful rapid disintegration of the formulated tablets and acceptable palatability.
RESUMO Recentes avanC'os em sistemas de liberaC'C#o de fC!rmacos novos visam C obtenC'C#o de melhor adesC#o do paciente. Um destes avanC'os C) a formulaC'C#o de comprimidos de desintegraC'C#o oral (ODTs), que se dissolvem instantaneamente, liberando o fC!rmaco, em alguns segundos, sem a necessidade de C!gua. O principal objetivo deste trabalho foi preparar e desenvolver ODTs de clopidogrel. Os ODTs foram preparados pelo mC)todo de compressC#o direta. Estudou-se o efeito de vC!rias concentraC'C5es de diferentes agentes de desintegraC'C#o, tais como super-crospovidona, croscarmelose de sC3dio, glicolato de amido de sC3dio no tempo de desintegraC'C#o e velocidade de dissoluC'C#o. Os comprimidos preparados foram avaliados quanto C dureza, C friabilidade, ao tempo de desintegraC'C#o e C liberaC'C#o do fC!rmaco in vitro. AlC)m disso, estudou-se a interaC'C#o de clopidogrel com os excipientes de formulaC'C#o, utilizando calorimetria de varredura diferencial (DSC). Estudos de DSC revelaram nC#o haver interaC'C#o entre o fC!rmaco e os excipientes utilizados. Todos os comprimidos possuC-am dureza na faixa de 4,0-5,2 kp e a friabilidade inferior a 1%. A variaC'C#o de peso e o teor de fC!rmaco de todas as formulaC'C5es mostraram-se dentro do limite oficial, de acordo com a BP. O estudo de liberaC'C#o do fC!rmaco in vitro de comprimidos ODTs mostrou que mais de 90% do fC!rmaco foram liberados em10 minutos. O teste de palatabilidade em voluntC!rios humanos mostrou sabor e sensaC'C#o na boca aceitC!veis. Assim, os resultados obtidos demonstraram, conclusivamente, a rC!pida e bem-sucedida desintegraC'C#o dos comprimidos formulados e a palatabilidade aceitC!vel.
Assuntos
Comprimidos/farmacocinética , Liberação Controlada de Fármacos/efeitos dos fármacos , Isquemia Mesentérica/prevenção & controleRESUMO
PURPOSE: To evaluate the effect of ischemic postconditioning(IPC) on intestinal mucosa of rats subjected to ischemia and reperfusion process comparing two cycles of reperfusion and ischemia lasting two minutes each and four cycles of reperfusion and ischemia lasting 30 seconds each. METHODS: Thirty Wistar rats were distributed into three groups: group A (10 rats), ischemia (30 minutes) and reperfusion (60 minutes); group B (10 rats), ischemia and reperfusion plus IPC by two lasting two minutes each; and Group C (10 rats), ischemia and reperfusion plus IPC by four cycles lasting 30 seconds each. Finally, a segment of small intestine was resected for histological analysis. We analysed the results according to Chiu et al. classification and proceeded to the statistical treatment by Kruskal-Wallis test (p<0.05). RESULTS: The mean degree of tissue injury according to Chiu et al. classification were: Group A, 2.77; in group B, 1.4; and group C, 1.4. B X C (p<0.05). CONCLUSIONS: Ischemic postconditioning was able to minimize reperfusion injury of rats undergone mesenteric ischemia and reperfusion process. There was no difference in the effectiveness of the method comparing two cycles of two minutes with four cycles of 30 seconds by H&E histological evaluation of the ileum after 60-minute reperfusion.
Assuntos
Mucosa Intestinal/irrigação sanguínea , Pós-Condicionamento Isquêmico/métodos , Isquemia Mesentérica/prevenção & controle , Traumatismo por Reperfusão/prevenção & controle , Animais , Íleo/irrigação sanguínea , Íleo/patologia , Mucosa Intestinal/patologia , Masculino , Isquemia Mesentérica/patologia , Ratos Wistar , Traumatismo por Reperfusão/patologia , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Fatores de TempoRESUMO
PURPOSE:To evaluate the effect of ischemic postconditioning(IPC) on intestinal mucosa of rats subjected to ischemia and reperfusion process comparing two cycles of reperfusion and ischemia lasting two minutes each and four cycles of reperfusion and ischemia lasting 30 seconds eachMETHODS: Thirty Wistar rats were distributed into three groups: group A (10 rats), ischemia (30 minutes) and reperfusion (60 minutes); group B (10 rats), ischemia and reperfusion plus IPC by two lasting two minutes each; and Group C (10 rats), ischemia and reperfusion plus IPC by four cycles lasting 30 seconds each. Finally, a segment of small intestine was resected for histological analysis. We analysed the results according to Chiu et al. classification and proceeded to the statistical treatment by Kruskal-Wallis test (p<0.05).RESULTS: The mean degree of tissue injury according to Chiu et al. classification were: Group A, 2.77; in group B, 1.4; and group C, 1.4. B X C (p<0.05).CONCLUSIONS: Ischemic postconditioning was able to minimize reperfusion injury of rats undergone mesenteric ischemia and reperfusion process. There was no difference in the effectiveness of the method comparing two cycles of two minutes with four cycles of 30 seconds by H&E histological evaluation of the ileum after 60-minute reperfusion.
Assuntos
Animais , Masculino , Mucosa Intestinal/irrigação sanguínea , Pós-Condicionamento Isquêmico/métodos , Isquemia Mesentérica/prevenção & controle , Traumatismo por Reperfusão/prevenção & controle , Íleo/irrigação sanguínea , Íleo/patologia , Mucosa Intestinal/patologia , Isquemia Mesentérica/patologia , Ratos Wistar , Reprodutibilidade dos Testes , Traumatismo por Reperfusão/patologia , Índice de Gravidade de Doença , Fatores de TempoRESUMO
Introduction: Ischemic postconditioning has been recognized as effective in the prevention of reperfusion injury in situations of ischemia and reperfusion in various organs and tissues. However, it remains unclear what would be the best way to accomplish it, since studies show great variation in the method of their application. Objective: To assess the protective effect of ischemic postconditioning on ischemia and reperfusion in rats undergoing five alternating cycles of reperfusion and ischemia of 30 seconds each one. Methods: We studied 25 Wistar rats distributed in three groups: group A (10 rats), which underwent mesenteric ischemia (30 minutes) and reperfusion (60 minutes); Group B (10 rats), undergoing ischemia (30 minutes) and reperfusion (60 minutes), intercalated by postconditioning (5 alternating cycles of reperfusion and ischemia of 30 seconds each one); and group C - SHAM (5 rats), undergoing only laparotomy and manipulation of mesenteric artery. All animals underwent resection of an ileum segment for histological analysis. Results: The mean lesions degree according to Chiu et al. were: group A, 2.77, group B, 2.67 and group C, 0.12. There was no difference between groups A and B (P>0.05). Conclusion: Ischemic postconditioning was not able to minimize or prevent the intestinal tissue injury in rats undergoing ischemia and reperfusion process when used five cycles lasting 30 seconds each one. .
Introdução: O pós-condicionamento isquêmico tem sido reconhecido como eficaz na prevenção das lesões de reperfusão em situações de isquemia e reperfusão em vários órgãos e tecidos. Entretanto, não está ainda claro qual seria a melhor maneira de realizá-lo, já que as publicações mostram grande variação de método no seu emprego. Objetivo: Avaliar o efeito protetor do pós-condicionamento isquêmico na isquemia e reperfusão intestinal em ratos, através de cinco ciclos alternados de 30 segundos de isquemia e 30 segundos de reperfusão. Métodos: Foram estudados 25 ratos Wistar, distribuídos em três grupos: grupo A (10 ratos), em que se realizou isquemia (30 minutos) e reperfusão (60 minutos) mesentérica; grupo B (10 ratos), isquemia e reperfusão, seguidos de pós-condicionamento isquêmico com 5 ciclos alternados de reperfusão e reoclusão, de 30 segundos cada; e grupo C (5 ratos), controle (SHAM). Ao final, ressecou-se um segmento do intestino delgado para análise histológica. Avaliaram-se os resultados pela classificação de Chiu et al. e procedeu-se ao tratamento estatístico. Resultados: As médias dos graus de lesão tecidual segundo a classificação de Chiu et al. foram: no grupo A, 2,77; no grupo B, 2,67; e no grupo C, 0,12. A diferença entre o resultado do grupo A com o resultado do grupo B não teve significância estatística (P>0,05). Conclusão: O pós-condicionamento isquêmico não foi capaz de minimizar ou prevenir a lesão tecidual intestinal de ratos submetidos ao processo de isquemia e reperfusão mesentérica quando utilizados cinco ciclos com duração de 30 segundos cada. .
Assuntos
Animais , Masculino , Intestinos/irrigação sanguínea , Pós-Condicionamento Isquêmico/métodos , Isquemia Mesentérica/prevenção & controle , Traumatismo por Reperfusão/prevenção & controle , Mucosa Intestinal/irrigação sanguínea , Mucosa Intestinal/patologia , Intestinos/patologia , Modelos Animais , Artérias Mesentéricas/patologia , Oclusão Vascular Mesentérica/patologia , Ratos Wistar , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Fatores de TempoRESUMO
INTRODUCTION: Ischemic postconditioning has been recognized as effective in the prevention of reperfusion injury in situations of ischemia and reperfusion in various organs and tissues. However, it remains unclear what would be the best way to accomplish it, since studies show great variation in the method of their application. OBJECTIVE: To assess the protective effect of ischemic postconditioning on ischemia and reperfusion in rats undergoing five alternating cycles of reperfusion and ischemia of 30 seconds each one. METHODS: We studied 25 Wistar rats distributed in three groups: group A (10 rats), which underwent mesenteric ischemia (30 minutes) and reperfusion (60 minutes); Group B (10 rats), undergoing ischemia (30 minutes) and reperfusion (60 minutes), intercalated by postconditioning (5 alternating cycles of reperfusion and ischemia of 30 seconds each one); and group C - SHAM (5 rats), undergoing only laparotomy and manipulation of mesenteric artery. All animals underwent resection of an ileum segment for histological analysis. RESULTS: The mean lesions degree according to Chiu et al. were: group A, 2.77, group B, 2.67 and group C, 0.12. There was no difference between groups A and B (P>0.05). CONCLUSION: Ischemic postconditioning was not able to minimize or prevent the intestinal tissue injury in rats undergoing ischemia and reperfusion process when used five cycles lasting 30 seconds each one.