ABSTRACT
Resumo Fundamento Tem surgido uma nova manifestação clínica chamada pós-COVID ou COVID longa (COVID p/l) após a fase aguda da COVID-19. COVID p/l pode levar à lesão miocárdica com problemas cardíacos subsequentes. Diagnosticar esses pacientes de forma rápida e simples é cada vez mais importante devido ao número crescente de pacientes com COVID p/l. Objetivos Comparamos os parâmetros de ecocardiografia com strain (ES) de pacientes que apresentaram dor torácica atípica e achados de sequelas de miocardite na ressonância magnética cardíaca (RMC). Nosso objetivo foi investigar o valor da ES para detecção de envolvimento miocárdico em pacientes com COVID p/l. Métodos Foram incluídos um total de 42 pacientes. Nossa população foi separada em 2 grupos. O grupo RMC(-) (n = 21) não apresentou sequelas miocárdicas na RMC, enquanto o grupo RMC(+) apresentou sequelas miocárdicas na RMC (n = 21). O valor preditivo da ES para miocardite também foi avaliado por análise multivariada ajustada por idade. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados Quando comparado com a fração de ejeção do ventrículo esquerdo (FEVE), o strain longitudinal global (SLG) e o strain circunferencial global (SCG) tiveram uma relação mais forte (FEVE, p = 0,05; SLG, p < 0,001; SCG, p < 0,001) com envolvimento miocárdico associado à COVID p/l. SLG < 20,35 apresentou sensibilidade de 85,7% e especificidade de 81%; SCG < 21,35 apresentou sensibilidade de 81% e especificidade de 81% como valores diagnósticos para sequelas miocárdicas detectadas com RMC. Enquanto não houve diferença entre os grupos quanto aos marcadores inflamatórios (proteína C-reativa, p = 0,31), houve diferença entre os marcadores bioquímicos, que são indicadores de envolvimento cardíaco (peptídeo natriurético cerebral, p < 0,001). Conclusão A ES é mais útil do que a ecocardiografia tradicional para diagnosticar com rapidez e precisão, a fim de não atrasar o tratamento na presença de envolvimento miocárdico.
Abstract Background A new clinical manifestation called post or long coronavirus disease (p/l COVID) has walked into our lives after the acute COVID-19 phase. P/l COVID may lead to myocardial injury with subsequent cardiac problems. Diagnosing these patients quickly and simply has become more important due to the increasing number of patients with p/l COVID. Objectives We compared strain echocardiography (SE) parameters of patients who suffered from atypical chest pain and had sequel myocarditis findings on cardiac magnetic resonance (CMR). We aimed to investigate the value of SE for detection of myocardial involvement in patients with p/l COVID. Methods A total of 42 patients were enrolled. Our population was separated into two groups. The CMR(-) group (n = 21) had no myocardial sequelae on CMR, whereas the CMR(+) group had myocardial sequelae on CMR (n = 21). The predictive value of SE for myocarditis was also evaluated by age-adjusted multivariate analysis. P values < 0.05 were considered statistically significant. Results When compared with left ventricular ejection fraction (LVEF), global longitudinal strain (GLS) and global circumferential strain (GCS) had a stronger relationship (LVEF, p = 0.05; GLS, p < 0.001; GCS, p < 0.001) with p/l COVID associated myocardial involvement. GLS < 20.35 had 85.7% sensitivity and 81% specificity; GCS < 21.35 had 81% sensitivity and 81% specificity as diagnostic values for myocardial sequelae detected with CMR. While there was no difference between the groups in terms of inflammatory markers (C-reactive protein, p = 0.31), a difference was observed between biochemical markers, which are indicators of cardiac involvement (brain natriuretic peptide, p < 0.001). Conclusion SE is more useful than traditional echocardiography for making diagnosis quickly and accurately in order not to delay treatment in the presence of myocardial involvement.
ABSTRACT
OBJECTIVES: To determine the serum and tissue levels of markers of impaired oxidative metabolism and correlate these levels with the histopathology and Alvarado score of acute appendicitis patients. METHOD: Sixty-five acute appendicitis patients (mean age, 31.4±12.06 years; male/female, 30/35) and 30 healthy control subjects were studied. The Alvarado score was recorded. Serum samples were obtained before surgery and 12 hours postoperatively to examine the total antioxidant status, total oxidant status, paraoxonase, stimulated paraoxonase, arylesterase, catalase, myeloperoxidase, ceruloplasmin, oxidative stress markers (advanced oxidized protein products and total thiol level) and ischemia-modified albumin. Surgical specimens were also evaluated. RESULTS: The diagnoses were acute appendicitis (n = 37), perforated appendicitis (n = 8), phlegmonous appendicitis (n = 12), perforated+phlegmonous appendicitis (n = 4), or no appendicitis (n = 4). The Alvarado score of the acute appendicitis group was significantly lower than that of the perforated+phlegmonous appendicitis group (p = 0.004). The serum total antioxidant status, total thiol level, advanced oxidized protein products, total oxidant status, catalase, arylesterase, and ischemia-modified albumin levels were significantly different between the acute appendicitis and control groups. There was no correlation between the pathological extent of acute appendicitis and the tissue levels of the markers; additionally, there was no correlation between the tissue and serum levels of any of the parameters. CONCLUSIONS: The imbalance of oxidant/antioxidant systems plays a role in the pathogenesis acute appendicitis. The Alvarado score can successfully predict the presence and extent of acute appendicitis. .
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Appendicitis/metabolism , Oxidative Stress/physiology , Reactive Oxygen Species/analysis , Acute Disease , Appendectomy , Antioxidants/analysis , Aryldialkylphosphatase/analysis , Biomarkers/analysis , Case-Control Studies , Carboxylic Ester Hydrolases/analysis , Prospective Studies , Peroxidases/analysis , Reference Values , Reactive Oxygen Species/metabolism , Statistics, Nonparametric , Serum Albumin/analysisABSTRACT
The aim of adipose tissue engineering is creating autologus vascularized fat tissue to be used for practical soft tissue reconstruction in human clinic. Unfortunately, in practice, long-term results of fat transplantation are often untrustworthy and unreliable, to overcome this problem different many lipoinjection techniques developed in the last 20 years. Centrifuge is a fundamental stepin the preparation of adipose tissue. We focused on some cell markers especially MSCs markers and histological structural properties after with lipokit centrifugation and without lipokit centrifugation of adipose tissue obtained by liposuction by this new technique. Adipose tissue was taken by liposuction and separates to two portions. One of them is centrifugated by Lipokit machine (C+) has a micro filter and the other is not (C-). After centrifugation smear slides and paraffin sections were prepared from these tissues. These slides were stained with H&E and Toluidine Blue. Paraffin sections were immunohistochemically stained with CD34, von Willebrand Factor, CD73, CD90 and CD105. Smear preparations showed a continuous three dimensional plasma membrane appearance of adipocytes. C+ and C- showed expression of CD34, von Willebrand Factor, CD73, CD90, CD105. C+ seems to have more free cells expressing than C-. While passing the filter of Lipokit, large adipocytes and connective tissue parts disintegrate and thus increases the surface area of lipoaspirate. Lipokit® machine release the group cells which are necessary for angiogenesis and they become more freely to construct angiogenesis.
El objetivo de la ingeniería del tejido adiposo es la creación de tejido graso vascularizado autólogo para ser utilizado en clínica humana para la reconstrucción de tejido blando. Desafortunadamente en la práctica, los resultados a largo plazo del trasplante de grasa son poco fiables y no seguros; para superar este problema, se han desarrollado en diferentes países, en los últimos 20 años, variadas técnicas de lipoinyección. La centrifugación es un paso fundamental en la preparación del tejido adiposo. Nos hemos centrado en algunos marcadores, especialmente, de células precursoras mesenquimales y propiedades histológicas estructurales después de la centrifugación mediante Lipokit y sin la centrifugación por Lipokit del tejido adiposo obtenido mediante liposucción. El tejido adiposo fue tomado por liposucción y se separó en dos porciones. Una se centrifugó mediante el sistema Lipokit (C +), con un microfiltro y la otro no (C-). Después de centrifugación, muestras del frotis y secciones de parafina se prepararon a partir de estos tejidos. Los frotis se tiñeron con H&E y azul de toluidina. Las secciones de parafina se tiñeron inmunohistoquímicamente con CD34, factor de von Willebrand, CD73, CD90 y CD105. Las preparaciones de los frotis mostraron una apariencia tridimensional continua de la membrana plasmática de los adipocitos. Tanto en C+ y C- se observó la expresión de CD34, factor de von Willebrand, CD73, CD90 y CD105. En C+ parecen expresarse más células libres que en C-. Cuando se utilizó el filtro de Lipokit, los adipocitos grandes y partes del tejido conectivo se desintegraron, por lo tanto aumentó el área de superficie de lipoaspirado. El sistema Lipokit® libera los grupos celulares que son necesarios para la angiogénesis y se hacen más libres para promoverla.