Exhaled and plasma nitrite: a comparative study among healthy, cirrhotic and liver transplant patients.

CONTEXT: There is a relative lack of studies about exhaled nitrite (NO2-) concentrations in cirrhotic and transplanted patients. OBJECTIVE: Verify possible differences and correlations between the levels of NO2-, measured in plasma and exhaled breath condensate collected from patients with cirrhosis and liver transplant. METHOD: Sixty adult male patients, aged between 27 and 67 years, were subdivided into three groups: a control group comprised of 15 healthy volunteers, a cirrhosis group composed of 15 volunteers, and a transplant group comprised of 30 volunteers. The NO2- concentrations were measured by chemiluminescence. RESULTS: 1) The analysis of plasma NO2- held among the three groups showed no statistical significance. 2) The comparison between cirrhotic and control groups, control and transplanted and cirrhotic and transplanted was not statistically significant. 3) The measurements performed on of NO2- exhaled breath condensate among the three groups showed no statistical difference. 4) When comparing the control group samples and cirrhotic, control and transplanted and cirrhotic and transplanted, there was no significant changes in the concentrations of NO2-. CONCLUSION: No correlations were found between plasma and exhaled NO2-, suggesting that the exhaled NO2- is more reflective of local respiratory NO release than the systemic circulation.

EXHALED AND PLASMA NITRITE: a comparative study among healthy, cirrhotic and liver transplant patients / Nitrito exalado e plasmático: um estudo comparativo entre pacientes transplantados saudáveis, cirrose e fígado

Context There is a relative lack of studies about exhaled nitrite (NO2-) concentrations in cirrhotic and transplanted patients. Objective Verify possible differences and correlations between the levels of NO2-, measured in plasma and exhaled breath condensate collected from patients with cirrhosis and liver transplant. Method Sixty adult male patients, aged between 27 and 67 years, were subdivided into three groups: a control group comprised of 15 healthy volunteers, a cirrhosis group composed of 15 volunteers, and a transplant group comprised of 30 volunteers. The NO2- concentrations were measured by chemiluminescence. Results 1) The analysis of plasma NO2- held among the three groups showed no statistical significance. 2) The comparison between cirrhotic and control groups, control and transplanted and cirrhotic and transplanted was not statistically significant. 3) The measurements performed on of NO2- exhaled breath condensate among the three groups showed no statistical difference. 4) When comparing the control group samples and cirrhotic, control and transplanted and cirrhotic and transplanted, there was no significant changes in the concentrations of NO2-. Conclusion No correlations were found between plasma and exhaled NO2-, suggesting that the exhaled NO2- is more reflective of local respiratory NO release than the systemic circulation. .

Contexto Observa-se relativa falta de estudos sobre nitrito (NO2-) exalado como biomarcador de lesão, após transplante de fígado. Objetivo Verificar possíveis diferenças e correlações entre os níveis de nitrito (NO2-), medido no plasma e condensado do exalado pulmonar de pacientes com cirrose e transplante de fígado. Método Sessenta pacientes adultos, masculinos, idades entre 27 e 67 anos, foram divididos em três grupos: grupo controle composto por 15 voluntários saudáveis, grupo cirrose, composto por 15 voluntários e, grupo de transplante, composto por 30 voluntários. As dosagens plasmáticas e do condensado do exalado pulmonar foram realizadas por quimioluminescência. Resultados A análise os valores de NO2- plasmático não mostrou diferença entre os grupos. As comparações entre grupos cirrose e controle, controle e transplantados e cirrose e transplante não foram significativas. As medidas em amostras de condensado do exalado pulmonar entre os três grupos não evidenciaram diferenças estatísticas. Ao comparar as amostras dos grupos controle e cirrótico, controle e transplantado e cirróticos e transplantados, não houve alterações significativas nas concentrações de NO2-. Conclusão Não foram encontradas correlações entre plasma e condensado do exalado pulmonar, sugerindo que o NO exalado reflete mais as condições respiratórias locais de liberação de NO do que a circulação sistêmica. .

Oxidative-stress biomarkers in patients with pulmonary hypertension.

This controlled, prospective, nonrandomized clinical investigation has as its chief strength the fact that it was done in humans with active disease and apparently on fairly modest therapeutic regimens. The aim was to present the results of oxidative-stress biomarkers in humans suffering from pulmonary artery hypertension (PAH). Inflammation and oxidative stress are essential in PAH with increased lipid peroxidation and reduced antioxidant defenses. Twenty-four adult patients of both sexes, with a mean age of 21 years, were subdivided into 2 groups: a control group of 12 healthy, nonsmoking volunteers and a PAH group (PAHG) of 12 volunteers with PAH receiving outpatient treatment. Oxidative stress was evaluated by plasma activity of reduced glutathione (GSH); lipid peroxidation was expressed by malondialdehyde (MDA) and lipid hydroperoxide (ferrous oxidation of xylenol orange [FOX] assay); vitamin E was measured by high-performance liquid chromatography and tumor necrosis factor-α (TNF-α) by enzyme-linked immunosorbent assay. Statistical analyses showed significant differences for (1) the TNF-α measure, with highest values in PAHG patients; (2) the plasma GSH, with lowest values in PAHG patients; (3) vitamin E, with the lowest concentrations in PAHG patients; (4) MDA measure, with highest values in PAHG patients; and (5) the lipid hydroperoxide FOX measure, with highest values in PAHG patients. In conclusion, inflammation and oxidative stress are present in patients with PAH, as confirmed by increased lipid peroxidation, reduced GSH, and low concentrations of vitamin E.

Comparação do uso da pressão positiva com a fisioterapia convencional e incentivadores respiratórios após cirurgia cardíaca: revisão de literatura / Comparison among positive pressure, standard physioterapy and incentive spirometry after cardiac surgery: literature review

Introdução: No pós-operatório de cirurgia cardíaca frequentemente ocorrem complicações pulmonares, as quais podem ser prevenidas e tratadas com técnicas específicas de fisioterapia respiratória. Porém não se sabe qual a técnica mais efetiva. Objetivo: Revisão de literatura com o objetivo de verificara efetividade da pressão positiva (CPAP, VNI-2P, RPPI) comparada às técnicas de fisioterapia convencional e incentivador respiratório (IR) na recuperação da função pulmonar em pacientes no pós-operatório de cirurgia cardíaca. Métodos: Seleção de referências em inglês e português com descritores específicos ao tema nas seguintes fontes de dados: BIREME, SciELO Brazil, LILACS, PUBMED, de 1985 até 2010. Foram incluídos apenas ensaios clínicos randomizados. Resultados: Dez ensaios clínicos randomizadosforam incluídos para revisão. Em relação à superioridade de uma técnica sobre a outra, doisestudos verificaram que a modalidade CPAP e VNI-2P mostrou-se mais efetiva do que a fisioterapia convencional e o IR, enquanto que em dois outros estudos, demonstrou-se a superioridade da VNI-2P, em relação ao uso de cateter de oxigênio e à fisioterapia convencional. Apenas um estudo demonstrou diferença significativa ao comparar duas modalidades de pressão positiva, sendo a RPPI mais efetiva que a CPAP...

Introduction: Postoperative pulmonary complications in patients undergoing cardiac surgeries are usually a clinical challenge, which can be prevented and treated with specific physical therapy techniques. However, it is not known which technique is the most effective. Objective: Literature review with the objective of assessing the effectiveness of positive pressure (CPAP, IPPB, NIV-2P) compared to standard physioterapy therapy and incentive spirometry on improving pulmonary function in postoperative cardiac surgery patients. Methods: English and Portuguese studies were used as references, searching for specific descriptors on the following data sources: BIREME, SciELO Brazil, LILACS, PUBMED, from 1985 to 2010. Only randomized clinical trials were included. Results: Ten randomized control trials were included in this review. About the most effective technique, two studies showed that CPAP and NIV-2P were more effective than standard physioterapy and incentive spirometry. In other two studies, NIV-2P were more effective than nasal oxygen catheter and standard physioterapy...