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1.
Sci Robot ; 8(76): eadd9369, 2023 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-36947599

RESUMO

Robot-actuated mechanical loading (ML)-based therapies ("mechanotherapies") can promote regeneration after severe skeletal muscle injury, but the effectiveness of such approaches during aging is unknown and may be influenced by age-associated decline in the healing capacity of skeletal muscle. To address this knowledge gap, this work used a noninvasive, load-controlled robotic device to impose highly defined tissue stresses to evaluate the age dependence of ML on muscle repair after injury. The response of injured muscle to robot-actuated cyclic compressive loading was found to be age sensitive, revealing not only a lack of reparative benefit of ML on injured aged muscles but also exacerbation of tissue inflammation. ML alone also disrupted the normal regenerative processes of aged muscle stem cells. However, these negative effects could be reversed by introducing anti-inflammatory therapy alongside ML application, leading to enhanced skeletal muscle regeneration even in aged mice.


Assuntos
Regeneração , Robótica , Animais , Camundongos , Regeneração/fisiologia , Músculo Esquelético/fisiologia , Anti-Inflamatórios
2.
J Dent Res ; 102(5): 497-504, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36883653

RESUMO

Oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS) are common chronic inflammatory conditions, manifesting as painful oral lesions that negatively affect patients' quality of life. Current treatment approaches are mainly palliative and often ineffective due to inadequate contact time of the therapeutic agent with the lesions. Here, we developed the Dental Tough Adhesive (DenTAl), a bioinspired adhesive patch with robust mechanical properties, capable of strong adhesion against diverse wet and dynamically moving intraoral tissues, and extended drug delivery of clobetasol-17-propionate, a first-line drug for treating OLP and RAS. DenTAl was found to have superior physical and adhesive properties compared to existing oral technologies, with ~2 to 100× adhesion to porcine keratinized gingiva and ~3 to 15× stretchability. Clobetasol-17-propionate incorporated into the DenTAl was released in a tunable sustained manner for at least 3 wk and demonstrated immunomodulatory capabilities in vitro, evidenced by reductions in several cytokines, including TNF-α, IL-6, IL-10, MCP-5, MIP-2, and TIMP-1. Our findings suggest that DenTAl may be a promising device for intraoral delivery of small-molecule drugs applicable to the management of painful oral lesions associated with chronic inflammatory conditions.


Assuntos
Clobetasol , Líquen Plano Bucal , Animais , Suínos , Clobetasol/uso terapêutico , Hidrogéis , Qualidade de Vida , Propionatos/uso terapêutico , Cimentos Dentários/uso terapêutico , Doença Crônica
3.
Sci Total Environ ; 769: 144804, 2021 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-33485200

RESUMO

Anthelmintics are antiparasitic drugs used to control helminthic parasites such as nematodes and trematodes in animals, particularly those exposed through pasture-based production systems. Even though anthelmintics have been shown to be excreted into the environment in relatively high amounts as unmetabolized drug or transformation products (TPs), there is still only limited information available on their environmental occurrence, particularly in groundwater, which has resulted in them being considered as potential emerging contaminants of concern. A comprehensive study was carried out to investigate the occurrence of 40 anthelmintic residues (including 13 TPs) in groundwaters (and associated surface waters) throughout the Republic of Ireland. The study focused on investigating the occurrence of these contaminants in karst and fractured bedrock aquifers, with a total of 106 sites (88 groundwaters and 18 surface waters) samples during spring 2017. Seventeen anthelmintic compounds consisting of eight parent drugs and nine TPs were detected at 22% of sites at concentrations up to 41 ng L-1. Albendazole and its TPs were most frequently detected residues, found at 8% of groundwater sites and 28% of surface water sites. Multivariate statistical analysis identified several source and pathway factors as being significantly related to the occurrence of anthelmintics in groundwater, however there was an evident localised effect which requires further investigation. An investigation of the temporal variations in occurrence over a 13 month period indicated a higher frequency and concentration of anthelmintics during February/March and again later during August/September 2018, which coincided with periods of increased usage and intensive meteorological events. This work presents the first detections of these contaminants in Irish groundwater and it contributes to broadening our understanding of anthelmintics in the environment. It also provides insight to seasonal trends in occurrence, which is critical for assessing potential future effects and implications of climate change.


Assuntos
Anti-Helmínticos , Água Subterrânea , Drogas Veterinárias , Poluentes Químicos da Água , Animais , Monitoramento Ambiental , Irlanda , Poluentes Químicos da Água/análise
4.
Sci Total Environ ; 746: 141116, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32758987

RESUMO

Intensification of the food production system to meet increased global demand for food has led to veterinary pharmaceuticals becoming a critical component in animal husbandry. Anticoccidials are a group of veterinary products used to control coccidiosis in food-producing animals, with primary prophylactic use in poultry production. Excretion in manure and subsequent land-spreading provides a potential pathway to groundwater. Information on the fate and occurrence of these compounds in groundwater is scant, therefore these substances are potential emerging organic contaminants of concern. A study was carried out to investigate the occurrence of anticoccidial compounds in groundwater throughout the Republic of Ireland. Twenty-six anticoccidials (6 ionophores and 20 synthetic anticoccidials) were analysed at 109 sites (63 boreholes and 46 springs) during November and December 2018. Sites were categorised and selected based on the following source and pathway factors: (a) the presence/absence of poultry activity (b) predominant aquifer category and (c) predominant groundwater vulnerability, within the zone of contribution (ZOC) for each site. Seven anticoccidials, including four ionophores (lasalocid, monensin, narasin and salinomycin) and three synthetic anticoccidials (amprolium, diclazuril and nicarbazin), were detected at 24% of sites at concentrations ranging from 1 to 386 ng L-1. Monensin and amprolium were the two most frequently detected compounds, detected at 15% and 7% of sites, respectively. Multivariate statistical analysis has shown that source factors are the most significant drivers of the occurrence of anticoccidials, with no definitive relationships between occurrence and pathway factors. The study found that the detection of anticoccidial compounds is 6.5 times more likely when poultry activity is present within the ZOC of a sampling point, compared to the absence of poultry activity. This work presents the first detections of these contaminants in Irish groundwater and it contributes to broadening our understanding of the environmental occurrence and fate of anticoccidial veterinary products.


Assuntos
Coccidiostáticos , Água Subterrânea , Doenças das Aves Domésticas , Drogas Veterinárias , Animais , Galinhas , Irlanda
5.
J Chromatogr A ; 1618: 460857, 2020 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31955842

RESUMO

A sensitive and selective method was developed and validated for the determination of 26 anticoccidial compounds (six ionophores and twenty chemical coccidiostats) in surface and groundwater samples at parts-per-quadrillion (pg L-1) to parts-per-trillion (ng L-1) levels by ultra-high performance liquid chromatography with tandem mass spectrometry detection (UHPLC-MS/MS). A range of different analytical columns and mobile phase compositions were evaluated to enhance selectivity and retention of a number of highly polar and basic anticoccidials along with other non-polar coccidiostats. A combined separation, including these problematic polar compounds, was achieved on a phenyl-hexyl column, by binary gradient elution with water/acetonitrile using ammonium formate and formic acid as additives. The anticoccidial residues were extracted from raw, unfiltered, water samples (250 mL) using polymeric divinylbenzene solid phase extraction (SPE) cartridges, with subsequent elution (methanol:acetonitrile:ethyl acetate, 40:40:20, v/v) and concentration prior to determination. The method recovery (at a concentration representative of realistic expected environmental water concentrations based on literature review) ranged from 81% to 105%. The method was successfully validated for 26 anticoccidials, at four concentration levels, in accordance to Commission Decision 2002/657/EC and SANTE/11813/2017 guidelines. Trueness and precision, under within-laboratory reproducibility conditions, ranged from 88% to 111% and 0.9% to 10.3% respectively.


Assuntos
Cromatografia Líquida de Alta Pressão/métodos , Coccidiostáticos/análise , Espectrometria de Massas em Tandem/métodos , Poluentes Químicos da Água/análise , Coccidiostáticos/isolamento & purificação , Formiatos/química , Reprodutibilidade dos Testes , Extração em Fase Sólida , Poluentes Químicos da Água/isolamento & purificação
6.
Sci Adv ; 5(7): eaaw3963, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31355332

RESUMO

Inspired by embryonic wound closure, we present mechanically active dressings to accelerate wound healing. Conventional dressings passively aid healing by maintaining moisture at wound sites. Recent developments have focused on drug and cell delivery to drive a healing process, but these methods are often complicated by drug side effects, sophisticated fabrication, and high cost. Here, we present novel active adhesive dressings consisting of thermoresponsive tough adhesive hydrogels that combine high stretchability, toughness, tissue adhesion, and antimicrobial function. They adhere strongly to the skin and actively contract wounds, in response to exposure to the skin temperature. In vitro and in vivo studies demonstrate their efficacy in accelerating and supporting skin wound healing. Finite element models validate and refine the wound contraction process enabled by these active adhesive dressings. This mechanobiological approach opens new avenues for wound management and may find broad utility in applications ranging from regenerative medicine to soft robotics.


Assuntos
Adesivos/farmacologia , Hidrogéis/farmacologia , Pele/efeitos dos fármacos , Cicatrização/fisiologia , Adesivos/síntese química , Adesivos/química , Animais , Antibacterianos/síntese química , Antibacterianos/química , Antibacterianos/farmacologia , Bandagens , Técnicas de Cultura de Células , Humanos , Hidrogéis/síntese química , Camundongos , Pele/patologia , Técnicas de Fechamento de Ferimentos
7.
J Dent Res ; 97(10): 1170-1177, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29649366

RESUMO

The goal of this study was to examine the effects of early and limited exposure of perivascular cells expressing α (αSMA) to fibroblast growth factor 2 (FGF2) in vivo. We performed in vivo fate mapping by inducible Cre-loxP and experimental pulp injury in molars to induce reparative dentinogenesis. Our results demonstrate that early delivery of exogenous FGF2 to exposed pulp led to proliferative expansion of αSMA-tdTomato+ cells and their accelerated differentiation into odontoblasts. In vivo lineage-tracing experiments showed that the calcified bridge/reparative dentin in FGF2-treated pulps were lined with an increased number of Dspp+ odontoblasts and devoid of BSP+ osteoblasts. The increased number of odontoblasts derived from αSMA-tdTomato+ cells and the formation of reparative dentin devoid of osteoblasts provide in vivo evidence for the stimulatory effects of FGF signaling on odontoblast differentiation from early progenitors in dental pulp.


Assuntos
Fator 2 de Crescimento de Fibroblastos/farmacologia , Odontoblastos/efeitos dos fármacos , Animais , Diferenciação Celular/efeitos dos fármacos , Polpa Dentária/efeitos dos fármacos , Polpa Dentária/crescimento & desenvolvimento , Citometria de Fluxo , Expressão Gênica/efeitos dos fármacos , Hibridização In Situ , Camundongos , Odontoblastos/metabolismo , Odontoblastos/fisiologia
9.
Eur J Trauma Emerg Surg ; 44(1): 15-18, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28597031

RESUMO

PURPOSE: Computed tomography scans of the abdomen/pelvis (CTAP) in the adult population may reveal findings unrelated to the injury, such as a mass; the occurrence of incidental findings in pediatric patients remains unknown. This study aims to determine the percentage of pediatric trauma patients with incidental findings. METHODS: Data regarding consecutive 250 patients who underwent CTAP during their evaluation were retrieved from our level 1 pediatric trauma center trauma registry. Interpretations were reviewed for mention of incidental findings. Records for patients with incidental findings were examined to determine what further evaluation occurred. RESULTS: Nine patients were excluded due to incomplete records. Of the remaining 241 patients, 114 incidental findings were identified among 86 (35.7%) patients. There were 47 clinically significant incidental findings, occurring in 41 (17%) patients. Seven patients (8.1%) had further workup of their findings; Three (3.5%) went on to have an operation (two patients with ureteropelvic junction obstruction and one with high-riding testicle). No potential tumors were found in this population. Incidental findings were mentioned in 25.5% of discharge summaries. CONCLUSIONS: Pediatric trauma CTAP reveals incidental findings at a lower rate than in their adult counterparts. Documentation of findings should be improved for optimal care of the injured child.


Assuntos
Traumatismos Abdominais/diagnóstico por imagem , Cuidados Críticos , Achados Incidentais , Pelve/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Traumatismos Abdominais/terapia , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Prevalência , Encaminhamento e Consulta , Sistema de Registros , Estudos Retrospectivos , Centros de Traumatologia , Adulto Jovem
10.
Science ; 357(6349): 378-381, 2017 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-28751604

RESUMO

Adhesion to wet and dynamic surfaces, including biological tissues, is important in many fields but has proven to be extremely challenging. Existing adhesives are cytotoxic, adhere weakly to tissues, or cannot be used in wet environments. We report a bioinspired design for adhesives consisting of two layers: an adhesive surface and a dissipative matrix. The former adheres to the substrate by electrostatic interactions, covalent bonds, and physical interpenetration. The latter amplifies energy dissipation through hysteresis. The two layers synergistically lead to higher adhesion energies on wet surfaces as compared with those of existing adhesives. Adhesion occurs within minutes, independent of blood exposure and compatible with in vivo dynamic movements. This family of adhesives may be useful in many areas of application, including tissue adhesives, wound dressings, and tissue repair.


Assuntos
Materiais Biocompatíveis/química , Adesivos Teciduais/química , Animais , Ratos , Eletricidade Estática , Suínos
11.
J Dent Res ; 93(12): 1250-7, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25143513

RESUMO

Tissue loss due to oral diseases requires the healing and regeneration of tissues of multiple lineages. While stem cells are native to oral tissues, a current major limitation to regeneration is the ability to direct their lineage-specific differentiation. This work utilizes polymeric scaffold systems with spatiotemporally controlled morphogen cues to develop precise morphogen fields to direct mesenchymal stem cell differentiation. First, a simple three-layer scaffold design was developed that presented two spatially segregated, lineage-specific cues (Dentinogenic TGF-ß1 and Osteogenic BMP4). However, this system resulted in diffuse morphogen fields, as assessed by the in vitro imaging of cell-signaling pathways triggered by the morphogens. Mathematical modeling was then exploited, in combination with incorporation of specific inhibitors (neutralizing antibodies or a small molecule kinase inhibitor) into each morphogen in an opposing spatial pattern as the respective morphogen, to design a five-layer scaffold that was predicted to yield distinct, spatially segregated zones of morphogen signaling. To validate this system, undifferentiated MSCs were uniformly seeded in these scaffold systems, and distinct mineralized tissue differentiation were noted within these morphogen zones. Finally, to demonstrate temporal control over morphogen signaling, latent TGF-ß1 was incorporated into one region of a concentric scaffold design, and laser treatment was used to activate the morphogen on-demand and to induce dentin differentiation solely within that specific spatial zone. This study demonstrates a significant advance in scaffold design to generate precise morphogen fields that can be used to develop in situ models to explore tissue differentiation and may ultimately be useful in engineering multi-lineage tissues in clinical dentistry.


Assuntos
Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Células-Tronco Mesenquimais/efeitos dos fármacos , Engenharia Tecidual/métodos , Animais , Proteína Morfogenética Óssea 4/farmacologia , Técnicas de Cultura de Células , Diferenciação Celular/efeitos dos fármacos , Linhagem da Célula/efeitos dos fármacos , Dentinogênese/efeitos dos fármacos , Difusão , Humanos , Ácido Láctico/química , Lasers Semicondutores , Camundongos , Modelos Biológicos , Osteogênese/efeitos dos fármacos , Comunicação Parácrina/efeitos dos fármacos , Ácido Poliglicólico/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Desenho de Prótese , Engenharia Tecidual/instrumentação , Alicerces Teciduais/química , Alicerces Teciduais/classificação , Fator de Crescimento Transformador beta1/farmacologia
12.
Minerva Chir ; 68(3): 263-74, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23774091

RESUMO

Thoracic and abdominal injuries in children are commonly the result of blunt trauma, making their diagnosis difficult. Unidentified injuries can cause significant morbidity and mortality and must be identified early. Understanding the anatomic and physiologic differences between children and adults is important to adequately manage children with these injuries. The following review provides salient points in the recognition and management of both thoracic and abdominal injuries in children from blunt trauma.


Assuntos
Traumatismos Abdominais , Traumatismos Torácicos , Traumatismos Abdominais/diagnóstico , Traumatismos Abdominais/terapia , Criança , Diafragma/lesões , Humanos , Lesão Pulmonar/diagnóstico , Lesão Pulmonar/terapia , Mediastino/lesões , Traumatismos Torácicos/diagnóstico , Traumatismos Torácicos/terapia , Ferimentos não Penetrantes
13.
Res Vet Sci ; 95(2): 644-7, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23642486

RESUMO

It has been observed that microbubbles may pass through the pulmonary circulation of dogs and humans during exercise. In humans, this phenomenon has been associated with lower pulmonary artery pressures, enhanced right ventricular function and greater exercise capacity. In the exercising Thoroughbred horse, extraordinarily high cardiac outputs exert significant pulmonary vascular stresses. The aim of this study was to determine, using contrast echocardiography, whether Thoroughbred horses performing strenuous exercise developed pulmonary transit of agitated contrast microbubbles (PTAC). At rest, agitated contrast was observed in the right ventricle, but not in the left ventricle. However, post-exercise microbubbles were observed in the left ventricle, confirming the occurrence of PTAC with exercise but not at rest. Further investigation is warranted to investigate whether this phenomenon may be associated with superior physiology and performance measures as has been implicated in other species.


Assuntos
Meios de Contraste/farmacologia , Cavalos/fisiologia , Pulmão/irrigação sanguínea , Microbolhas/veterinária , Condicionamento Físico Animal/fisiologia , Circulação Pulmonar/fisiologia , Animais , Masculino
14.
J Theor Biol ; 274(1): 120-30, 2011 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-21255586

RESUMO

Integrin receptors bind to adhesion ligand (e.g. arginine-glycine-aspartic acid or RGD containing peptides) on extracellular matrix and organize into high-density complexes which mediate many cell behaviors. Biomaterials with RGD nanopatterned into multivalent "islands" (∼30-70 nm diameter) have been shown to alter cell responses, although the length scale of pattern features is orders of magnitude smaller than adhesion complexes. In this work, we employ together for the first time an extensive data set on osteoblast responses as a function of ligand nanopatterns, a computational model of integrin binding to ligand nanopatterns, and new measures of integrin organization on the cell surface. We quantify, at multiple length scales, integrin organization generated in silico as a function of RGD nanopattern parameters. We develop a correlative model relating these measures of in silico integrin organization and in vitro MC3T3 preosteoblast cell responses as functions of the same RGD nanopatterns: cell spreading correlates with the number of bound integrins, focal adhesion kinase (FAK) phosphorylation correlates with small, homogeneously distributed clusters of integrins, and osteogenic differentiation correlates with large, heterogeneously distributed integrin clusters. These findings highlight the significance of engineering biomaterials at the nanolevel and suggest new approaches to understanding the mechanisms linking integrin organization to cell responses.


Assuntos
Integrinas/metabolismo , Nanoestruturas/química , Osteoblastos/citologia , Osteoblastos/metabolismo , Animais , Adesão Celular , Diferenciação Celular , Linhagem Celular , Movimento Celular , Proteína-Tirosina Quinases de Adesão Focal/metabolismo , Ligantes , Camundongos , Modelos Biológicos , Oligopeptídeos/química , Oligopeptídeos/metabolismo , Osteoblastos/enzimologia , Osteogênese , Fosforilação , Ligação Proteica
15.
Oral Dis ; 17(3): 241-51, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20860763

RESUMO

Oral Diseases (2011) 17, 241-251 The rapid advancement in basic biology knowledge, especially in the stem cell field, has created new opportunities to develop biomaterials capable of orchestrating the behavior of transplanted and host cells. Based on our current understanding of cellular differentiation, a conceptual framework for the use of materials to program cells in situ is presented, namely a domino vs a switchboard model, to highlight the use of single vs multiple cues in a controlled manner to modulate biological processes. Further, specific design principles of material systems to present soluble and insoluble cues that are capable of recruiting, programming and deploying host cells for various applications are presented. The evolution of biomaterials from simple inert substances used to fill defects, to the recent development of sophisticated material systems capable of programming cells in situ is providing a platform to translate our understanding of basic biological mechanisms to clinical care.


Assuntos
Materiais Biocompatíveis/farmacologia , Células-Tronco/efeitos dos fármacos , Engenharia Tecidual/métodos , Adesão Celular/efeitos dos fármacos , Moléculas de Adesão Celular/farmacologia , Diferenciação Celular/efeitos dos fármacos , Fenômenos Fisiológicos Celulares/efeitos dos fármacos , Regeneração Tecidual Guiada/métodos , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Ácidos Nucleicos/farmacologia
16.
J Nanosci Nanotechnol ; 9(6): 3506-13, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19504876

RESUMO

Nano-thick siloxane coatings with thickness in the range 1-33 nm were deposited using a reel-to-reel atmospheric plasma coating system. The coatings were deposited from a tetraethoxysilane (TEOS) precursor which was nebulised into a helium plasma. An issue influencing coating performance is the incorporation of particulates, which are formed during the deposition process. By systematically varying the process parameters such as plasma power, TEOS flow rate, gas flow rates (He, O2, and N2), a correlation was obtained between the deposition conditions and particulate formation. The effect of process parameters on growth rate, changes in coating chemistry and particulate formation on the deposited nm-thick films were studied by spectroscopic ellipsometry, contact angle/surface energy measurements, optical profilometry, Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), X-ray reflectometry (XRR), Scanning electron microscopy (SEM) and Atomic force microscopy (AFM). Larger numbers of particulates were formed under the conditions of higher plasma power, with the addition of O2 or N2 into the He plasma and also at both very low and high TEOS flow rates in the range 10-200 microl/min. Low plasma input power and moderate precursor flow rates (approx. 25 microl/min) significantly reduced particulate formation.

17.
Food Chem Toxicol ; 47(6): 1246-54, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19249334

RESUMO

Calendula flower (Calendula officinalis) (CF) has been used in herbal medicine because of its anti-inflammatory activity. CF and C. officinalis extracts (CFE) are used as skin conditioning agents in cosmetics. Although data on dermal irritation and sensitization of CF and CFE's are available, the risk of subchronic systemic toxicity following dermal application has not been evaluated. The threshold of toxicological concern (TTC) is a pragmatic, risk assessment based approach that has gained regulatory acceptance for food and has been recently adapted to address cosmetic ingredient safety. The purpose of this paper is to determine if the safe use of CF and CFE can be established based upon the TTC class for each of its known constituents. For each constituent, the concentration in the plant, the molecular weight, and the estimated skin penetration potential were used to calculate a maximal daily systemic exposure which was then compared to its corresponding TTC class value. Since the composition of plant extracts are variable, back calculation was used to determine the maximum acceptable concentration of a given constituent in an extract of CF. This paper demonstrates the utility and practical application of the TTC concept when used as a tool in the safety evaluation of botanical extracts.


Assuntos
Calendula/toxicidade , Cosméticos/toxicidade , Calendula/química , Química Farmacêutica , Flores/química , Flores/toxicidade , Humanos , Peso Molecular , Nível de Efeito Adverso não Observado , Extratos Vegetais/toxicidade , Medição de Risco , Absorção Cutânea
18.
Heart ; 94(7): 860-6, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17483127

RESUMO

BACKGROUND: There is evidence that ultra-endurance exercise causes myocardial injury. The extent and duration of these changes remains unresolved. Recent reports have speculated that structural adaptations to exercise, particularly of the right ventricle, may predispose to tachyarrhythmias and sudden cardiac death. OBJECTIVE: To quantify the extent and duration of post-exercise cardiac injury with particular attention to right ventricular (RV) dysfunction. METHODS: 27 athletes (20 male, 7 female) were tested 1 week before, immediately after and 1 week after an ultra-endurance triathlon. Tests included cardiac troponin I (cTnI), B-type natriuretic peptide (BNP) and comprehensive echocardiographic assessment. RESULTS: 26 athletes completed the race and testing procedures. Post-race, cTnI was raised in 15 athletes (58%) and the mean value for the entire cohort increased (0.17 vs 0.49 microg/l, p<0.01). BNP rose in every athlete and the mean increased significantly (12.2 vs 42.5 ng/l, p<0.001). Left ventricular ejection fraction (LVEF) was unchanged (60.4% vs 57.5%, p = 0.09), but integrated systolic strain decreased (16.9% vs 15.1%, p<0.01). New regional wall motion abnormalities developed in seven athletes (27%) and LVEF was reduced in this subgroup (57.8% vs 45.9%, p<0.001). RV function was reduced in the entire cohort with decreases in fractional area change (0.47 vs 0.39, p<0.01) and tricuspid annular plane systolic excursion (21.8 vs 19.1 mm, p<0.01). At follow-up, all variables returned to baseline except in one athlete where RV dysfunction persisted. CONCLUSION: Myocardial damage occurs during intense ultra-endurance exercise and, in particular, there is a significant reduction in RV function. Almost all abnormalities resolve within 1 week.


Assuntos
Exercício Físico/fisiologia , Resistência Física/fisiologia , Disfunção Ventricular Esquerda/fisiopatologia , Disfunção Ventricular Direita/fisiopatologia , Adulto , Biomarcadores/sangue , Ecocardiografia Doppler em Cores/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/sangue , Troponina I/sangue , Disfunção Ventricular Esquerda/sangue , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Direita/sangue , Disfunção Ventricular Direita/diagnóstico por imagem , Disfunção Ventricular Direita/etiologia
20.
J Pediatr Surg ; 42(2): 340-4, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17270545

RESUMO

BACKGROUND: Nonoperative management (NOM) is an accepted treatment of pediatric solid organ injuries and is typically successful. Blunt pancreatic trauma tends to require operative intervention more frequently. We sought to identify predictors of failure of NOM and compare the outcome of operative management against NOM. METHODS: A retrospective analysis was performed from January 1993 to December 2002 of all children with blunt pancreatic injuries from the trauma registries of 7 designated level 1 pediatric trauma centers. Failure of NOM was defined as the need for intraabdominal operative intervention. Injuries were graded I to V, and ductal injury was defined as grades III to V. Parameters included mechanism of injury, injury severity score (ISS), organ grade, Glasgow Coma Scale score, and outcome. Data were analyzed by Fisher exact test and Mann-Whitney U test, with mean values +/- SD and significance of P < .05. RESULTS: Pancreatic injuries were present in 173 (9.2%) of 1823 patients. Of these, 43 (26.0% [43/173]) required an operation. Valid morbidity data was obtained in 118 of 173 patients. ISS was significantly higher in all patients treated operatively. Patients with an injury of grade III to V failed NOM more frequently than all patients with pancreatic injury (P =.0169). Length of stay was longer, and the incidence of pseudocysts, drainage procedures, and pancreatitis was higher in NOM patients, although not significant. CONCLUSIONS: Patients with pancreatic injuries had a NOM failure rate of 26.0%. ISS and injury grades III to V were predictors of NOM failure. Patients with pancreatic ductal injury require more aggressive management.


Assuntos
Traumatismos Abdominais/diagnóstico , Traumatismos Abdominais/terapia , Pâncreas/lesões , Pancreatopatias/terapia , Adolescente , Criança , Pré-Escolar , Colangiopancreatografia Retrógrada Endoscópica , Feminino , Seguimentos , Humanos , Lactente , Escala de Gravidade do Ferimento , Masculino , Pâncreas/cirurgia , Pancreatectomia/métodos , Pancreatopatias/diagnóstico , Pancreatopatias/etiologia , Probabilidade , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Tomografia Computadorizada por Raios X , Centros de Traumatologia , Falha de Tratamento , Ferimentos não Penetrantes/diagnóstico , Ferimentos não Penetrantes/terapia
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