RESUMO
This study was performed to evaluate whether the use of drugs in the treatment of osteoporosis in women is associated with COVID-19 outcomes. The results showed that the risk of hospitalization, intensive care unit admission, and mortality was not altered in individuals taking anti-osteoporosis drugs, suggesting no safety issues during a COVID-19 infection. INTRODUCTION: Whether patients with COVID-19 receiving anti-osteoporosis drugs have lower risk of worse outcomes has not been reported yet. The aim of this study was to evaluate the association of anti-osteoporosis drug use with COVID-19 outcomes in women. METHODS: Data obtained from a nationwide, multicenter, retrospective cohort of patients diagnosed with COVID-19 from March 11th to May 30th, 2020 was retrieved from the Turkish Ministry of Health Database. Women 50 years or older with confirmed COVID-19 who were receiving anti-osteoporosis drugs were compared with a 1:1 propensity score-matched COVID-19 positive women who were not receiving these drugs. The primary outcomes were hospitalization, ICU (intensive care unit) admission, and mortality. RESULTS: A total of 1997 women on anti-osteoporosis drugs and 1997 control patients were analyzed. In the treatment group, 1787 (89.5%) women were receiving bisphosphonates, 197 (9.9%) denosumab, and 17 (0.9%) teriparatide for the last 12 months. Hospitalization and mortality rates were similar between the treatment and control groups. ICU admission rate was lower in the treatment group (23.0% vs 27.0%, p = 0.013). However, multivariate analysis showed that anti-osteoporosis drug use was not an independent associate of any outcome. Hospitalization, ICU admission, and mortality rates were similar among bisphosphonate, denosumab, or teriparatide users. CONCLUSION: Results of this nationwide study showed that preexisting use of anti-osteoporosis drugs in women did not alter the COVID-19-related risk of hospitalization, ICU admission, and mortality. These results do not suggest discontinuation of these drugs during a COVID-19 infection.
Assuntos
COVID-19 , Osteoporose , Preparações Farmacêuticas , Estudos de Coortes , Feminino , Humanos , Osteoporose/tratamento farmacológico , Osteoporose/epidemiologia , Estudos Retrospectivos , SARS-CoV-2RESUMO
Cattle plays a very important role in agriculture and food security in Algeria. In the present study, the genetic diversity and structure of Algerian indigenous cattle populations were evaluated by microsatellite markers. A total of 138 individuals belonging to four cattle breed populations were characterized using 22 microsatellite markers. A total of 360 alleles was detected across studied all loci. Results obtained for the mean number of alleles (16.36), expected heterozygosity (0.84) and polymorphic information content (0.82) indicated that the total analyzed populations are characterized by noticeable genetic variability. It can be said that there is a low genetic differentiation in the cattle populations studied considering obtained mean FST value (0.039). It was revealed 97.10% of the total genetic variation can be explained by genetic differences among individuals while 2.90% among populations. The structure, factorial correspondence analysis results and dendrogram showed that cattle populations studied are clustered in three groups. The present study has revealed an important knowledge about the genetic diversity and the relationship between some native cattle breeds raised in Algeria. The results showed that the breeds studied have a high genetic diversity. Moreover, it can be said that microsatellite markers used can be successfully used to determine genetic diversity and population structure in Algerian cattle breeds.
Assuntos
Bovinos , Repetições de Microssatélites , Argélia , Animais , Cruzamento , Bovinos/genética , Variação Genética , Genética PopulacionalRESUMO
OBJECTIVES: The aim of our study is to investigate biochemical and histopathological effects of lutein on the ovarian ischemia-reperfusion (I/R) injury in rats. BACKGROUND: Reactive oxygen species and cytokines have a very important role in the pathogenesis of I/R injury. Lutein and its derivatives may show an anti-inflammatory effect in relation to the decrease in inflammatory cytokines and increase in antioxidant enzymes. METHODS: Wistar albino female rats were randomly divided into three groups before surgery as follows: I/R group (IRG; n = 6), 1 mg/kg lutein + I/R group (LIRG; n = 6), and a healthy control group scheduled for a sham operation (SG; n = 6). The condition of ovarian ischemia was created by vascular clips. After two hours, the ovary was reperfused. Then, cyclooxygenase-1, cyclooxygenase-2, malondialdehyde and total glutathione levels were examined in ovary tissues of rats. RESULTS: As the results of our study demonstrated, in ovarian tissues of animals after I/R, there was an increase in the levels of malondialdehyde and cyclooxygenase-2, while total glutathione and cyclooxygenase-1 were decreased. At the same time, it has been observed however that these ratios are reversed in the LIRG group (p < 0.05). CONCLUSION: Lutein ameliorates the I/R-induced ovarian injury in rats by its antioxidative and anti-inflammatory activities (Fig. 2, Ref. 39).
Assuntos
Luteína , Ovário , Traumatismo por Reperfusão , Animais , Antioxidantes , Feminino , Luteína/farmacologia , Malondialdeído , Ovário/irrigação sanguínea , Distribuição Aleatória , Ratos , Ratos Wistar , Traumatismo por Reperfusão/tratamento farmacológicoRESUMO
Tularemia is a zoonotic infection caused by Francisella tularensis with a worldwide distribution and diverse clinical manifestations. Although F. tularensis has been recognized as a human pathogen for a century, there are few reports regarding the occurrence of tularemia in pregnant women and its effect on the fetus; only seven cases have been reported in the literature. In view of the sparse literature, it is not clear whether tularemia increases the risk of adverse pregnancy outcomes. In this paper we review tularemia infection during pregnancy, its complications and management. In addition, we present a case of tularemia that occurred in the first trimester of pregnancy and resulted in third-trimester intrauterine fetal death, highlighting the consequences of tularemia in pregnancy and the importance of early detection and treatment.
Assuntos
Antibacterianos/uso terapêutico , Francisella tularensis/isolamento & purificação , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Tularemia/diagnóstico , Tularemia/tratamento farmacológico , Feminino , Humanos , Gravidez , Complicações Infecciosas na Gravidez/patologia , Resultado da Gravidez , Tularemia/patologiaRESUMO
Objective: The objective of this research was to determine the impact of glucocorticoid treatment on preventing scarring of lung parenchyma in COVID-19 patients by considering their health behavior. Methods: A sample of 65 Turkish patients who had pneumonia and were hospitalized between March/December 2020 were included in this research. The data for this research was collected after the consent of the hospital. The structural equation model approach was used in data analysis and empirical findings. Results: The research identified that the patients with appropriate health behavior were satisfied with their clinical treatment of scarring of lung parenchyma by the method of glucocorticoid treatment. The research also identified that the patient's health behavior was a significant indicator to improve their perception of the clinical treatment. Conclusion: This study has reliable theoretical implications that are significantly important in the literature because of the nature and uniqueness of the findings. However, this research also has some practical implications related to the patient's lungs mostly infected by COVID-19. Furthermore, the findings of this research can be generalized in a significant way because the respondents of this research belonged to a diverse population.
Assuntos
COVID-19 , Humanos , Glucocorticoides/uso terapêutico , SARS-CoV-2 , Cicatriz , Pulmão/diagnóstico por imagemRESUMO
Background: Infections with multidrug-resistant Gram-negative bacteria such as Acinetobacter baumannii are major cause of morbidity and mortality. Colistin is used commonly to treat these infections. In this study, we evaluated the efficacy of different colistin combinations in a A. baumannii infection mouse model. Materials & methods: An A. baumannii mouse infection model was developed in 150 experimental animals. Treatment groups were as follows: colistin, colistin + rifampicin, colistin + trimethoprim/sulfamethoxazole, colistin + teicoplanin and a control group. The outcome was bacterial burden in the lung and liver tissues. The treatment groups were subdivided into 24-, 48- and 72-h groups. Results: Colistin and combinations reduce the A. baumannii burden significantly in lung and liver tissues compared with the control group. Compared with colistin alone colistin + rifampicin and colistin + TMP-SMX provided significantly better reduction in the bacterial burden. Conclusion: These results may suggest that rifampicin and TMP-SMX combination with colistin may have a potential role in the treatment of A. baumannii infections.
Assuntos
Infecções por Acinetobacter , Acinetobacter baumannii , Infecções por Acinetobacter/microbiologia , Animais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Colistina/farmacologia , Colistina/uso terapêutico , Modelos Animais de Doenças , Camundongos , Rifampina/farmacologia , Rifampina/uso terapêutico , Teicoplanina/farmacologia , Teicoplanina/uso terapêutico , Combinação Trimetoprima e Sulfametoxazol/farmacologia , Combinação Trimetoprima e Sulfametoxazol/uso terapêuticoRESUMO
OBJECTIVE: This study evaluated the effect of low-energy radiofrequency thermocoagulation added to standard liquid sclerotherapy on clinical outcomes of patients with venous insufficiency. PATIENTS AND METHOD: We included 111 patients with spider veins CEAP/C1 stage. The patients were randomized into sclerotherapy (Group 1) and sclerotherapy + sclerotherapy immediately followed by low energy percutaneous RF thermocoagulation (Group 2) groups and followed up with same protocols prospectively. RESULTS: The study groups did not differ in terms of the mean age, body mass index, the number of spider veins and pre-interventional venous clinical severity scores (VCSS). Patients' self-assessed satisfaction ratings of cosmetic outcomes were found to be higher compared to the baseline (p = 0.001). While both techniques caused a significant decline in VCSS at postprocedural third month, it was observed that the type of applied intervention did not affect the VCSS (p = 0.43 and p = 0.93, respectively). There was a significant difference in hyperpigmentation and trapped blood between the two groups after the procedure (p = 0.009 and p = 0.02, respectively), there was no statistically significant difference in terms of skin necrosis (p = 0.52). A significant difference in the self-assessed cosmetic outcomes was observed in patients treated with sclerotherapy followed by low energy percutaneous RF thermocoagulation compared with patients whom sclerotherapy performed alone (p = 0.001). DISCUSSION: This study suggests that radiofrequency thermocoagulation added to the sclerotherapy provides better cosmetic outcomes with less treatment sessions and no additional complication rates.
Assuntos
Telangiectasia , Varizes , Eletrocoagulação , Humanos , Perna (Membro) , Projetos Piloto , Veia Safena , Escleroterapia , Resultado do Tratamento , Varizes/terapiaRESUMO
OBJECTIVES: Sibutramine is a selective inhibitor of the reuptake of monoamines. Plasma levels of brain natriuretic peptide (BNP) appear to be inversely associated with body mass index (BMI) in subjects with and without heart failure for reasons that remain unexplained. The aim of this study was to investigate the possible influence of sibutramine treatment on BNP levels in severely obese patients. METHODS: Fifty-two severely obese female patients with BMI > 40 kg/m(2) were included to this study. The women were recommended to follow a weight-reducing daily diet of 25 kcal/kg of ideal body weight. During the treatment period, all patients were to receive 15 mg of sibutramine once a day. Blood chemistry tests were performed before the onset of the medication and after 12 weeks of treatment. RESULTS: None of the subjects was withdrawn from the study because of the adverse effects of sibutramine. Body weight (108.8 +/- 13.3 kg vs. 101.7 +/- 15.6 kg, p < 0.001), BMI (44.6 +/- 4.6 kg/m(2) vs. 41.8 +/- 5.7 kg/m(2), p < 0.001) and BNP [8.6 (0.5-49.5) ng/l vs. 3.1 (0.2-28.6) ng/l, p = 0.018] levels were significantly decreased after 12 weeks of sibutramine treatment. Total cholesterol (5.19 +/- 0.90 mmol/l vs. 4.82 +/- 1.05 mmol/l respectively; p < 0.001), low-density lipoprotein-cholesterol (3.26 +/- 0.86 mmol/l vs. 2.99 +/- 0.40 mmol/l respectively; p = 0.008), levels were significantly decreased; however, there was no significant alteration in high-density lipoprotein-cholesterol and triglyceride levels. CONCLUSION: This study has shown a decrease in BNP levels which may lead to improvement in cardiac outcome after sibutramine treatment. Further randomised studies are needed to be conducted to clarify the relationship between sibutramine and BNP.
Assuntos
Depressores do Apetite/uso terapêutico , Ciclobutanos/uso terapêutico , Peptídeo Natriurético Encefálico/metabolismo , Obesidade/tratamento farmacológico , Biomarcadores/metabolismo , Índice de Massa Corporal , LDL-Colesterol/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: There is a gap in the knowledge concerning oral anticoagulation (OAC) in atrial fibrillation (AF) patients with a non-high risk of stroke. CHA2DS2VASc and CHADS2 scores generated imprecise risk estimates for low risk patients. We aimed to assess OAC in patients with low risk by CHADS2 and reclassified as high-risk by CHA2DS2VASc. PATIENTS AND METHODS: In this study, retrospective nationwide population-based study, data were obtained from the Turkish claims and utilization management system. Patients with non-valvular AF (n=451,113) between 2007 and 2012 sub-divided into those with a CHA2DS2VASc≥1 and CHADS2=0 (n=41,273) who were off-warfarin (n=29,448) and on-warfarin (n=11,825). Stroke and systemic embolism, major bleeding, all-cause mortality, net clinical benefit (NCB) and ultimate NCB (UNCB) were assessed. RESULTS: Of the total cohort (mean age 66.1 ± 14.1 years, 56.1% female), CHA2DS2VASc improved the net reclassification index of observed 5-year composite thromboembolic endpoint by 6.9% (p<0.05). CHA2DS2VASc reclassified 9.7% low risk patients as high risk. Among reclassified-high-risk category (patients with a CHA2DS2VASc score of ≥1 and CHADS2 score of 0), major bleeding for that prescribed warfarin was 3% and higher than the rate of thromboembolism among those off-warfarin. NCB (-0.035) and UNCB (-0.021) were negative. Death and hospitalization at 1 year were significantly higher for on-warfarin group. CONCLUSIONS: Clinical outcomes, net clinical benefit indices are negative; rates of death and hospitalization were significantly higher for OAC in reclassified category. This emphasizes the importance of greater attention to balancing the risks and benefits of OAC in patients with low risk by CHADS2 and reclassified as high-risk by CHA2DS2VASc.
Assuntos
Anticoagulantes/efeitos adversos , Fibrilação Atrial/complicações , Idoso , Estudos de Coortes , Diabetes Mellitus Tipo 2/complicações , Feminino , Insuficiência Cardíaca/complicações , Humanos , Hipertensão/complicações , Masculino , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/complicações , TurquiaRESUMO
INTRODUCTION AND HYPOTHESIS: Peritonisation of mesh during Abdominal sacrocolpopexy is generally advocated to prevent adhesions to the viscera; however, randomized clinical trials are lacking. In this study; we aimed to investigate whether the mesh peritonisation is clinically significant or not. MATERIAL METHOD: Thirty-four patients who were operated for the reason of pelvic organ prolapse were included in the study. Patients were divided into two groups by retrospective scanning from the files and surgical reports. Group 1 patients consisted of those who underwent peritonisation and group 2 patients consisted of those who did not in abdominal sacrocolpopexy. RESULTS: Operative time and the amount of blood lost were statistically less in the group 2. Postoperative pain and analgesic drug requirements were obviously higher in the group 1. Postoperative De novo dyspareunia and urinary urgency were higher in the group 1. There were no statistical differences between the groups in terms of other complications. CONCLUSION: We noticed that there was no difference between the patients who were peritonized and those who were not in terms of postoperative complications.
Assuntos
Parede Abdominal/cirurgia , Prolapso de Órgão Pélvico/cirurgia , Peritônio/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Telas Cirúrgicas/efeitos adversos , Adulto , Analgésicos/uso terapêutico , Perda Sanguínea Cirúrgica/prevenção & controle , Estudos Transversais , Dispareunia/epidemiologia , Dispareunia/etiologia , Dispareunia/prevenção & controle , Feminino , Seguimentos , Humanos , Incidência , Pessoa de Meia-Idade , Duração da Cirurgia , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/fisiopatologia , Dor Pós-Operatória/prevenção & controle , Prolapso de Órgão Pélvico/fisiopatologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia , Estudos Retrospectivos , Índice de Gravidade de Doença , Aderências Teciduais/epidemiologia , Aderências Teciduais/etiologia , Aderências Teciduais/prevenção & controle , Turquia/epidemiologia , Incontinência Urinária de Urgência/epidemiologia , Incontinência Urinária de Urgência/etiologia , Incontinência Urinária de Urgência/prevenção & controleRESUMO
We compared the effectiveness of local anaesthetic with Emla cream with that of an injection of lidocaine for radiofrequency reduction of the inferior turbinates. We studied 98 consecutive patients with hypertrophied inferior turbinates, 46 of whom were given Emla cream and 52 lidocaine injection. The procedure began five minutes after the injection of lidocaine and 10minutes after the Emla cream had been applied. Patients were asked to indicate on a visual analogue scale (VAS) the degree of perioperative pain, anxiety, sensation of choking, and discomfort on swallowing that they felt after the procedure. Patients treated with Emla had significantly lower VAS scores for discomfort on swallowing than those treated with lidocaine (p=0.001), but there were no other significant differences between the two groups. We conclude that Emla cream is an efficacious alternative to infiltration of lidocaine for radiofrequency reduction of the inferior turbinates.
Assuntos
Anestesia Local/métodos , Anestésicos Locais/uso terapêutico , Ablação por Cateter/métodos , Lidocaína/uso terapêutico , Obstrução Nasal/cirurgia , Manejo da Dor/métodos , Prilocaína/uso terapêutico , Conchas Nasais/cirurgia , Adolescente , Adulto , Idoso , Feminino , Humanos , Combinação Lidocaína e Prilocaína , Masculino , Pessoa de Meia-Idade , Medição da Dor , Ondas de Rádio , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Ultrasound scanning traits have been adapted in selection programs in many countries to improve carcass traits for lean meat production. As the genetic parameters of the traits interested are important for breeding programs, the estimation of these parameters was aimed at the present investigation. The estimated parameters were direct and maternal heritability as well as genetic correlations between the studied traits. The traits were backfat thickness (BFT), skin+backfat thickness (SBFT), eye muscle depth (MD) and live weights at the day of scanning (LW). The breed investigated was Kivircik, which has a high quality of meat. Six different multi-trait animal models were fitted to determine the most suitable model for the data using Bayesian approach. Based on deviance information criterion, a model that includes direct additive genetic effects, maternal additive genetic effects, direct maternal genetic covariance and maternal permanent environmental effects revealed to be the most appropriate for the data, and therefore, inferences were built on the results of that model. The direct heritability estimates for BFT, SBFT, MD and LW were 0.26, 0.26, 0.23 and 0.09, whereas the maternal heritability estimates were 0.27, 0.27, 0.24 and 0.20, respectively. Negative genetic correlations were obtained between direct and maternal effects for BFT, SBFT and MD. Both direct and maternal genetic correlations between traits were favorable, whereas BFT-MD and SBFT-MD had negligible direct genetic correlation. The highest direct and maternal genetic correlations were between BFT and SBFT (0.39) and between MD and LW (0.48), respectively. Our results, in general, indicated that maternal effects should be accounted for in estimation of genetic parameters of ultrasound scanning traits in Kivircik lambs, and SBFT can be used as a selection criterion to improve BFT.
Assuntos
Cruzamento , Carne/análise , Fenótipo , Carneiro Doméstico/fisiologia , Ultrassonografia/veterinária , Animais , Teorema de Bayes , Feminino , Masculino , Modelos Genéticos , Carneiro Doméstico/genética , TurquiaRESUMO
PURPOSE: Recent studies have revealed that growth hormone and STAT5 were related to hepatosteatosis in mice. Loss of signal transducer and activator of transcription factor-5 leads to hepatosteatosis and impaired liver regeneration. We aimed to investigate the role of IGF-1 in steatosis with normal (SNLFT) and disturbed liver function tests (SDLFT) in humans. METHODS: We included 272 NAFLD patients and 110 age, sex and body mass index (BMI)-matched healty controls. We measured routine blood biochemistry and complete blood count, IGF-1, insulin, c-peptide, ferritin, hsCRP, ESR and HOMA-IR. We subdivided NAFLD patients into SNLFT and SDLFT subgroups. RESULTS: ge, sex and BMI were similar between NAFLD and controls. IGF-1 levels were significantly lower in NAFLD patients (120,6±48,2) than controls (148,9±53,8), (<0,0001). IGF-1 levels were also lower in SDLFT subgroup (93,4±27,8) than SNLFT subgroup (123,1±49,0), (p:0,032). Waist circumference, fasting blood glucose, HbA1c, uric acid, hsCRP, AST, ALT, GGT, WBC, hemoglobin, hematocrit, ferritin, insulin, c-peptid and HOMA-IR measurements were significantly higher in NAFLD patients than controls (for all values: p<0,0001).Cholesterol (p:0,026), triglycerides (p<0,0001), ESR (p:0,006) were significantly higher in NAFLD patients than controls. HDL-chelesterol levels were significantly lower (p:0,002) in NAFLD patients than controls. CONCLUSION: This study supported previous findings of experi-mental studies in that, IGF-1 levels were lower in SNLFT and SDLFT. Growth hormone-IGF-1 system may be involved in the pathogenesis of NAFLD.
Assuntos
Fígado Gorduroso/sangue , Fator de Crescimento Insulin-Like I/metabolismo , Adulto , Estudos de Casos e Controles , Fígado Gorduroso/fisiopatologia , Humanos , Testes de Função Hepática , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: This study compared the pain associated with the intratympanic injection combined with various local anaesthetics vs without anaesthesia. METHODS: The study included 40 patients (aged 18-78 years) who received intratympanic steroid injections for sudden idiopathic hearing loss or tinnitus. Each patient underwent all three injection methods at one-week intervals. Patients received one of two local anaesthetics (lidocaine injection or lidocaine spray) or no anaesthesia before intratympanic injection, and used a visual analogue scale to indicate the pain level after 5 and 45 minutes. RESULTS: Five minutes after injection, patients who did not receive anaesthesia and those who received lidocaine spray reported lower pain scores than those who received a lidocaine injection (p < 0.05). There was no difference in pain scores for all three methods at 45 minutes after intratympanic injection. CONCLUSION: Neither of the local anaesthetics was found to be superior to having no anaesthesia.
Assuntos
Anestésicos Locais/administração & dosagem , Dexametasona/uso terapêutico , Glucocorticoides/uso terapêutico , Perda Auditiva Súbita/tratamento farmacológico , Lidocaína/administração & dosagem , Dor/prevenção & controle , Zumbido/tratamento farmacológico , Administração Tópica , Adolescente , Adulto , Idoso , Anestésicos Locais/uso terapêutico , Feminino , Humanos , Injeção Intratimpânica , Injeções Subcutâneas , Lidocaína/uso terapêutico , Masculino , Pessoa de Meia-Idade , Dor/fisiopatologia , Medição da Dor , Dor Pós-Operatória/fisiopatologia , Dor Pós-Operatória/prevenção & controle , Adulto JovemRESUMO
BACKGROUND: Carotid endarterectomy (CEA) is the treatment of choice for patients with symptomatic and asymptomatic high-grade carotid stenosis. In literature there are papers advocating patch plasty for better results. But there is controversy about which patch material is optimal for use. This study compared rate of neurologic events, and perioperative death in patients undergoing CEA with primary closure versus patch closure. METHODS: We compared patch angioplasty to primary closure between August 2008 and December 2012 in 57 operations. Patients grouped according to their closure technique. Early (30-day) stroke and mortality rate were evaluated. Mean age of patients was 67.79±10.19 (range 41-85 years). 15 (26.31%) of patients were female. RESULTS: Primary closure was used in 13 operations, and patch angioplasty was used in 44 (saphenous vein: 5, Dacron: 23, Fabric: 5, Carotid: 11). There were no significant differences among groups' baseline characteristics. Primary closure was associated with significantly more postoperative major stroke compared with patch used closure (P=0.05). None of preoperative variables were associated with postoperative stroke. CONCLUSIONS: On the basis of our results, avoiding primary closure for CEA is defendable. But choice of patch material needs large trials to conclude.
Assuntos
Angioplastia/instrumentação , Implante de Prótese Vascular/instrumentação , Prótese Vascular , Estenose das Carótidas/cirurgia , Endarterectomia das Carótidas , Polietilenotereftalatos , Veia Safena/transplante , Acidente Vascular Cerebral/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Angioplastia/efeitos adversos , Angioplastia/mortalidade , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/mortalidade , Estenose das Carótidas/complicações , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/mortalidade , Endarterectomia das Carótidas/efeitos adversos , Endarterectomia das Carótidas/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/mortalidade , Fatores de Tempo , Resultado do TratamentoRESUMO
Tumor invasion into extracellular matrix (ECM) and basement membrane (BM) is a crucial step in the complex multistage process that leads to metastasis formation. GG6-10 galloylglucose, isolated from Galla Rhois, inhibited the invasion of metastatic HT-1080 cells into a reconstituted BM, such as a Matrigel/fibronectin (FN)-coated filter, in a concentration-dependent fashion. GG6-10 affected neither the tumor cell adhesion and haptotactic migration to ECM components (Matrigel and FN), nor the growth of HT-1080 cells. The gelatin zymography revealed that GG6-10 was able to inhibit not only the degradation of gelatin mediated by matrix metalloproteinases (MMP)-2 and -9 in conditioned medium of HT-1080 tumor cells but also the production of MMP from the tumor cells in a concentration-dependent manner. MMP production is well known to be positively regulated by various cytokines, such as tumor necrosis factor-alpha (TNF-alpha). Thus, we examined the effect of GG6-10 on the TNF-alpha-mediated translation of the MMP-9 gene using HT-1080 cells transfected with the MMP-9 promoter linked to the luciferase gene as a reporter. Similarly to prednisolone, GG6-10 was found to inhibit the TNF-alpha-inducible promoter activity. In keeping with these results, GG6-10 might inhibit tumor cell invasion by inhibiting the gelatinolysis mediated by MMP-2 and -9 and interfering with the production of MMP via inhibiting transcription of the promoter for MMP.
Assuntos
Taninos Hidrolisáveis , Invasividade Neoplásica , Taninos/farmacologia , Adesão Celular/efeitos dos fármacos , Movimento Celular/efeitos dos fármacos , Colágeno/metabolismo , Colagenases/metabolismo , Matriz Extracelular , Gelatinases/metabolismo , Humanos , Metaloproteinase 9 da Matriz , Células Tumorais CultivadasRESUMO
BACKGROUND: Electrical cardioversion (ECV) in patients with atrial fibrillation (AF) is known to be associated with an increased peri-procedural risk for thromboembolic events. ECV of AF for at least 3 weeks of effective oral anticoagulation was recently determined to be disassociated with occurrence of cerebral circulating microemboli (ME). Nonetheless, whether ECV in patients undergoing short-term anticoagulation with heparin is concomitant with cerebral ME still remains obscure. The objective of this study was to determine whether or not short-term anticoagulation with heparin helps avoid microemboli before and immediately after cardioversion of AF in patients undergoing transesophageal echocardiography (TEE)-guided ECV. METHOD: A total of 34 patients (21 women, aged 61+/-12 years) who underwent TEE-guided ECV were enrolled into the study. All the patients underwent treatment with heparin for 3 days for anticoagulation before ECV. Transcranial Doppler ultrasonography (TCD) of the right middle cerebral artery and left middle cerebral artery was simultaneously performed through the temporal skull with a two-channel 2-MHz probe in all patients lasting for 30 min before ECV and 30 min immediately after successive ECV. RESULTS: No ME were detected in 34 patients during the 30-min period during AF before ECV. Similarly, after ECV no ME were observed during 30-min monitoring in 27 patients who were converted to sinus rhythm. None of the patients presented with clinical signs or symptoms suggestive of manifest cerebral embolism either before or after ECV. CONCLUSION: TCD monitoring did not disclose any evidence of microemboli in short-term anticoagulated patients with heparin before and immediately after TEE-guided ECV.
Assuntos
Anticoagulantes/efeitos adversos , Anticoagulantes/uso terapêutico , Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/terapia , Ecocardiografia Transesofagiana/efeitos adversos , Cardioversão Elétrica/efeitos adversos , Heparina/efeitos adversos , Heparina/uso terapêutico , Embolia Intracraniana/diagnóstico por imagem , Embolia Intracraniana/etiologia , Complicações Pós-Operatórias , Ultrassonografia Doppler Transcraniana , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de TempoRESUMO
We investigated the clinical and electrophysiological features of monomorphic ventricular tachycardia (MVT) with different initiation patterns in patients with implantable cardioverter defibrillator to assess whether there is a relationship between the initiation patterns of sustained MVT and clinical characteristics, and the efficacy of antiarrhythmic and electrical therapy. Fifty-five stored IECGs in twenty-two patients with MVT were evaluated. All MVT episodes were classified as initiating with ventricular premature beats (non-sudden onset MVT) or without ventricular ectopy preceding tachycardia (sudden onset MVT). Non-sudden onset MVT was characterized by shorter tachycardia cycle length (CL) and required higher shock energy for termination. Sudden onset MVT was precipitated by shortening of the sinus CL before tachycardia and was more common with relatively better preserved systolic function.
Assuntos
Desfibriladores Implantáveis , Sistema de Condução Cardíaco/fisiopatologia , Taquicardia Ventricular/fisiopatologia , Idoso , Estudos de Casos e Controles , Eletrocardiografia , Humanos , Taquicardia Ventricular/etiologia , Complexos Ventriculares Prematuros/fisiopatologiaRESUMO
BACKGROUND: Cardiac troponin levels do not rise to marked levels after external cardioversion of atrial fibrillation. Subsequent test discharges during implantation of cardioverter defibrillators may cause an elevation of cardiac troponin levels, but are still controversial. OBJECTIVE: To determine whether the biomarkers of cardiac injury increase after internal cardioversion (IC) of atrial fibrillation. METHODS: Forty-four patients with chronic atrial fibrillation were studied (mean age 59 +/-7 years). Electrode catheters were inserted through the femoral vein. One of these was positioned in the lower right atrium. A second defibrillation electrode was placed in the coronary sinus and an additional catheter was positioned in the right ventricular apex in order to obtain satisfactory R wave synchronization and to provide postshock ventricular pacing. The shocks were delivered by external defibrillator. Starting with a test shock of 1 J intensity, the energy was increased in steps (to maximum 15 J) until cardioversion was achieved. At least 1 min was permitted to elapse between unsuccessful defibrillation attempts before the next shock was applied. Blood samples for serum levels of cardiac troponin T, cardiac troponin I, creatine kinase MB and myoglobin were drawn before and 2 h, 4 h, 8 h and 24 h after IC. Each level of biomarker was compared with baseline. RESULTS: In 40 of 44 patients, IC was successful at a mean cardioversion threshold of 7.6+/-3.3 J. Although the serum levels of these biomarkers tended to rise, marked elevation was not detected in any of samples (P>0.05 for each). There was no correlation between the levels of biomarkers and the number and energy of shocks applied. No severe complications were observed. CONCLUSIONS: Following uncomplicated IC of atrial fibrillation, cardiac biomarkers do not rise to marked levels, which indicates that significant myocardial injury does not occur by shocks in the usual dosage.
Assuntos
Fibrilação Atrial/terapia , Cardioversão Elétrica , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/etiologia , Idoso , Fibrilação Atrial/sangue , Fibrilação Atrial/fisiopatologia , Biomarcadores/sangue , Doença Crônica , Creatina Quinase/sangue , Creatina Quinase Forma MB , Feminino , Humanos , Isoenzimas/sangue , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/sangue , Mioglobina/sangue , Estatística como Assunto , Volume Sistólico/fisiologia , Resultado do Tratamento , Troponina I/sangue , Troponina T/sangueRESUMO
Although atrial fibrillation is one of the most frequent and widespread cardiac arrhythmias, there is not sufficient data on frequency and electrical cardioversion of this arrhythmia in cases of dextrocardia. The present case report describes a 66-year-old woman with atrial fibrillation and dextrocardia who was admitted to hospital with a complaint of palpitations; no cause of the atrial fibrillation was found. Electrical cardioversion was performed for termination of the arrhythmia. By placing the anterior paddle in the right parasternal area and the lateral paddle in the area where the apex of the left ventricle palpated at the right side of the chest, cardioversion was performed and sinus rhythm was achieved.