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1.
Oral Microbiol Immunol ; 19(4): 257-61, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15209997

RESUMO

A number of pathogenic microorganisms have been previously shown to bind plasminogen. The subsequent activation of plasminogen into plasmin can contribute to their virulence. In this study, we have shown that Streptococcus mutans is able to bind both human plasminogen and plasmin. Binding of plasminogen to S. mutans was inhibited by L-lysine and epsilon-aminocaproic acid, indicating that binding is mediated via lysine-binding sites of plasminogen. S. mutans enhanced the activation of plasminogen by tissue plasminogen activator but not by urokinase. This enhancement turned out to be dependent on cell concentration. Zymogram analysis showed that the plasmin activity acquired after plasminogen binding and activation is the most important proteolytic activity in the strain tested. These results suggest a mechanism involving acquisition of a host protease that might contribute to the infective process of this microorganism.


Assuntos
Plasminogênio/metabolismo , Streptococcus mutans/metabolismo , Aminocaproatos/farmacologia , Sítios de Ligação , Fibrinolisina/metabolismo , Humanos , Técnicas In Vitro , Lisina/farmacologia , Ligação Proteica/efeitos dos fármacos , Streptococcus mutans/genética , Virulência
2.
Mol Biochem Parasitol ; 110(2): 183-93, 2000 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11071275

RESUMO

The binding of human plasminogen and plasmin to the promastigote form of Leishmania mexicana was investigated. L. mexicana was capable to bind both molecules, the binding being inhibited by epsilon-aminocaproic acid. Scatchard plot analysis revealed a dissociation constant (Kd) value of 2.4+/-0.8 microM and 0.9+/-0.1 x 10(4) binding sites per cell for plasminogen and a Kd value of 1.2+/-0.4 microM and 1.6+/-0.2 x 10(5) binding sites per cell for plasmin. C-terminal lysine residues are involved in plasminogen binding to cells, since carboxypeptidase B treatment reduced this binding by 34%. Ligand blotting analysis showed a group of proteins, with molecular masses between 105 and 115 kDa, capable to interact with plasminogen. Zymogram analysis showed that the protease activity acquired by L. mexicana, due to the interaction with either plasminogen or plasmin, comprises an important fraction of the total protease activity at pH 7.7. Plasminogen activation by tissue-type plasminogen activator (t-PA) was enhanced by the presence of L. mexicana promastigotes. These results raise the question whether the interaction of L. mexicana with components of the fibrinolytic system is involved in the virulence of the parasite.


Assuntos
Fibrinolisina/metabolismo , Leishmania mexicana/metabolismo , Plasminogênio/metabolismo , Animais , Carboxipeptidases/metabolismo , Humanos , Immunoblotting , Leishmania mexicana/crescimento & desenvolvimento , Peptídeo Hidrolases/metabolismo , Ligação Proteica , Proteínas de Protozoários/metabolismo , Ativador de Plasminogênio Tecidual/metabolismo , Ativador de Plasminogênio Tipo Uroquinase/metabolismo
3.
Braz J Med Biol Res ; 33(9): 1015-21, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10973131

RESUMO

The interaction of plasminogen, tissue plasminogen activator (t-PA) and urokinase with a clinical strain of Helicobacter pylori was studied. Plasminogen bound to the surface of H. pylori cells in a concentration-dependent manner and could be activated to the enzymatic form, plasmin, by t-PA. Affinity chromatography assays revealed a plasminogen-binding protein of 58.9 kDa in water extracts of surface proteins. Surface-associated plasmin activity, detected with the chromogenic substrate CBS 00.65, was observed only when plasminogen and an exogenous activator were added to the cell suspension. The two physiologic plasminogen activators, t-PA and urokinase, were also shown to bind to and remain active on the surface of bacterial cells. epsilon-Aminocaproic acid caused partial inhibition of t-PA binding, suggesting that the kringle 2 structure of this activator is involved in the interaction with surface receptors. The activation of plasminogen by t-PA, but not urokinase, strongly depended on the presence of cells and a 25-fold enhancer effect on the initial velocity of activation by t-PA compared to urokinase was established. Furthermore, a relationship between cell concentration and the initial velocity of activation was demonstrated. These findings support the concept that plasminogen activation by t-PA on the bacterial surface is a surface-dependent reaction which offers catalytic advantages.


Assuntos
Fibrinolíticos/metabolismo , Helicobacter pylori/metabolismo , Ativadores de Plasminogênio/metabolismo , Ativador de Plasminogênio Tecidual/metabolismo , Aminocaproatos/metabolismo , Cromatografia , Eletroforese em Gel de Poliacrilamida , Humanos , Indicadores e Reagentes , Receptores de Superfície Celular/metabolismo , Ativador de Plasminogênio Tipo Uroquinase/metabolismo
4.
Braz. j. med. biol. res ; 33(9): 1015-21, Sept. 2000.
Artigo em Inglês | LILACS | ID: lil-267977

RESUMO

The interaction of plasminogen, tissue plasminogen activator (t-PA) and urokinase with a clinical strain of Helicobacter pylori was studied. Plasminogen bound to the surface of H. pylori cells in a concentration-dependent manner and could be activated to the enzymatic form, plasmin, by t-PA. Affinity chromatography assays revealed a plasminogen-binding protein of 58.9 kDa in water extracts of surface proteins. Surface-associated plasmin activity, detected with the chromogenic substrate CBS 00.65, was observed only when plasminogen and an exogenous activator were added to the cell suspension. The two physiologic plasminogen activators, t-PA and urokinase, were also shown to bind to and remain active on the surface of bacterial cells. epsilon-Aminocaproic acid caused partial inhibition of t-PA binding, suggesting that the kringle 2 structure of this activator is involved in the interaction with surface receptors. The activation of plasminogen by t-PA, but not urokinase, strongly depended on the presence of cells and a 25-fold enhancer effect on the initial velocity of activation by t-PA compared to urokinase was established. Furthermore, a relationship between cell concentration and the initial velocity of activation was demonstrated. These findings support the concept that plasminogen activation by t-PA on the bacterial surface is a surface-dependent reaction which offers catalytic advantages


Assuntos
Humanos , Fibrinolíticos/metabolismo , Helicobacter pylori/metabolismo , Ativadores de Plasminogênio/metabolismo , Ativador de Plasminogênio Tecidual/metabolismo , Aminocaproatos/metabolismo , Cromatografia , Eletroforese em Gel de Poliacrilamida , Helicobacter pylori/isolamento & purificação , Indicadores e Reagentes , Receptores de Superfície Celular/metabolismo , Ativador de Plasminogênio Tipo Uroquinase/metabolismo
5.
J Biol Chem ; 275(13): 9447-51, 2000 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-10734091

RESUMO

The activation of oxidized phosphoribulokinase either "free" or as part of a bi-enzyme complex by reduced thioredoxins during the enzyme reaction was studied. In the presence of reduced thioredoxin, the product of the reaction catalyzed by phosphoribulokinase within the bi-enzyme complex does not appear in a linear fashion. It follows a mono-exponential pattern that suggests a slow dissociation process of the bi-enzyme complex in the assay cuvette. A plot of the steady state of product appearance against thioredoxin concentration gave a sigmoid curve. On the basis of our experimental results, we propose a minimum model of the activation of phosphoribulokinase by reduced thioredoxin. Reduced thioredoxin may act on the phosphoribulokinase, either within the complex or in the dissociated metastable form. However, the time required to activate the enzyme as part of the complex is shorter (about 20 s) than that required to activate the dissociated form (about 10 min). This might be of physiological relevance, and we discuss the role of the interactions between phosphoribulokinase and glyceraldehyde-3-phosphate dehydrogenase in the regulation of the Calvin cycle.


Assuntos
Chlamydomonas reinhardtii/enzimologia , Cloroplastos/enzimologia , Fosfotransferases (Aceptor do Grupo Álcool)/metabolismo , Tiorredoxinas/metabolismo , Animais , Ativação Enzimática , Gliceraldeído-3-Fosfato Desidrogenases/metabolismo , Cinética , Modelos Químicos
6.
Braz. j. med. biol. res ; 30(12): 1427-30, Dec. 1997. ilus, graf
Artigo em Inglês | LILACS | ID: lil-212586

RESUMO

We cloned the streptokinase (STK) gene of Streptococcus equisimilis in an expression vector of Escherichia coli to overexpress the profibrinolytic protein under the control of a tac promoter. Almost all the recombinant STK was exported to the periplasmic space and recovered after gentle lysozyme digestion of induced cells. The periplasmatic fraction was chromatographed on DEAE Sepharose followed by chromatography on phenyl-agarose. Active proteins eluted between 4.5 and 0 percent ammonium sulfate, when a linear grandient was applied. Theree major STK derivatives of 47.5 kDa, 45 kDa and 32 kDa were detected by Western blot analysis with a polyclonal antibody. The 32-kDa protein formed a complex with human plasminogen but did not exhibit Glu-plasminogen activator activity, as revealed by a zymographic assay, whereas the 45-kDa protein showed a Km = 0.70 muM and kcat = 0.82 s(-1), when assayed with a chromogen-coupled subtrate. These results suggest that these proteins are putative fragments of STK, possibly derived from partial degradation during the export pathway or the purification steps. The 47.5-kDa band corresponded to the native STK, as revealed by peptide sequencing.


Assuntos
Clonagem Molecular , Escherichia coli , Proteínas Recombinantes , Streptococcus/genética , Estreptoquinase/genética , Estreptoquinase/isolamento & purificação , Cromatografia em Agarose
7.
Eur J Biochem ; 246(1): 78-84, 1997 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-9210468

RESUMO

A bienzyme complex made up of phosphoribulokinase and glyceraldehyde-3-phosphate dehydrogenase has been isolated and purified from chloroplasts of Chlamydomonas reinhardtii. The complex contains four phosphoribulokinase and eight glyceraldehyde-3-phosphate dehydrogenase polypeptide chains. As phosphoribulokinase is dimeric and glyceraldehyde-3-phosphate dehydrogenase tetrameric, it is concluded that the complex comprises two phosphoribulokinase and two glyceraldehyde-3-phosphate dehydrogenase molecules. Its overall molecular mass is 460 kDa, which is in excellent agreement with its stoichiometry. Moreover, owing to the nature of the two enzymes, this complex must catalyse two nonconsecutive reactions. The bienzyme complex tended to spontaneously dissociate into the free enzymes upon dilution. This dissociation process was considerably promoted by reducing agents such as dithiothreitol or reduced thioredoxin. The kinetics of the dissociation process induced by dithiothreitol or reduced thioredoxin were paralleled by an increase of activity of phosphoribulokinase. The dissociation of the complex was reversible. If oxidized phosphoribulokinase and glyceraldehyde-3-phosphate dehydrogenase were mixed, a certain amount of the complex was formed. The reconstituted complex displayed properties that were indistinguishable from those of the native complex extracted from chloroplasts of Chlamydomonas reinhardtii. These results suggest that the concentration of the complex in vivo must vary depending on the light intensity.


Assuntos
Chlamydomonas reinhardtii/enzimologia , Gliceraldeído-3-Fosfato Desidrogenases/química , Complexos Multienzimáticos/química , Fosfotransferases (Aceptor do Grupo Álcool)/química , Animais , Western Blotting , Cloroplastos/enzimologia , Cromatografia DEAE-Celulose , Cromatografia em Gel , Ditiotreitol/farmacologia , Durapatita , Gliceraldeído-3-Fosfato Desidrogenases/isolamento & purificação , Gliceraldeído-3-Fosfato Desidrogenases/metabolismo , Peso Molecular , Complexos Multienzimáticos/isolamento & purificação , Complexos Multienzimáticos/metabolismo , NAD/metabolismo , NADP/metabolismo , Fosfotransferases (Aceptor do Grupo Álcool)/isolamento & purificação , Fosfotransferases (Aceptor do Grupo Álcool)/metabolismo , Conformação Proteica , Tiorredoxinas/farmacologia
8.
Eur J Biochem ; 246(1): 85-91, 1997 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-9210469

RESUMO

Oxidized, free, stable phosphoribulokinase from Chlamydomonas reinhardtii was almost completely devoid of catalytic activity (0.06 s(-1)/site). However, when it was bound to glyceraldehyde-3-phosphate dehydrogenase from the same organism, it displayed significant activity (3.25 s(-1)/site). Moreover, this complex tended to spontaneously dissociate upon dilution; the isolated phosphoribulokinase activity increased up to 56 s(-1)/site, subsequently decreased, and finally became almost completely inactive. Its intrinsic kinetic properties (Km and k(cat)) changed with the variation of the overall activity. These effects were paralleled by changes of conformation of the enzyme as revealed by fluorescence analysis. A model is proposed that allows quantitative expression of the dynamics of the dissociation of the oxidized bienzyme complex and the effects of either of the two substrates, ATP and ribulose 5-phosphate, on this dissociation process. Whereas ATP destabilized the complex and promoted its dissociation, ribulose 5-phosphate tended to stabilize this complex. Inactive, stable, oxidized phosphoribulokinase may form a complex with glyceraldehyde-3-phosphate dehydrogenase regaining its catalytic activity. In this case, glyceraldehyde-3-phosphate dehydrogenase acts in a manner similar, but not identical to a chaperonin. The information content of the phosphoribulokinase gene, as defined by the sequence of its base pairs, was therefore not sufficient to specify full enzyme activity. It needed the presence of glyceraldehyde-3-phosphate dehydrogenase to give the oxidized phosphoribulokinase a conformation competent for its activity. The potential biological significance of these effects remains to be discovered.


Assuntos
Chlamydomonas reinhardtii/enzimologia , Gliceraldeído-3-Fosfato Desidrogenases/metabolismo , Complexos Multienzimáticos/metabolismo , Fosfotransferases (Aceptor do Grupo Álcool)/metabolismo , Trifosfato de Adenosina/metabolismo , Animais , Cloroplastos/enzimologia , Ativação Enzimática , Estabilidade Enzimática , Fluorescência , Glutationa/farmacologia , Cinética , Modelos Químicos , Oxirredução , Fosfotransferases (Aceptor do Grupo Álcool)/química , Conformação Proteica , Ribulosefosfatos/metabolismo , Triptofano
9.
Eur J Biochem ; 250(2): 286-95, 1997 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-9428675

RESUMO

Oxidized phosphoribulokinase is almost inactive in its isolated state but becomes active when associated with glyceraldehyde-3-phosphate dehydrogenase. There is therefore an information transfer that takes place between these two enzymes. However, when the complex dissociates, free oxidized phosphoribulokinase is even more active than when it is associated with glyceraldehyde-3-phosphate dehydrogenase. This means that glyceraldehyde-3-phosphate dehydrogenase exerts an imprinting effect upon phosphoribulokinase which persists for a while after the parting of the two proteins. Various methods derived from statistical thermodynamics can be used to estimate the fraction of energy transferred from glyceraldehyde-3-phosphate dehydrogenase to phosphoribulokinase and which alters the kinetic parameters of the latter enzyme. In the complex, the decrease of the free energy associated with the binding of ribulose 5-phosphate is larger than that of ATP. This implies that the mutual association of the two enzymes facilitates the binding of the former substrate but is without effect on that of the latter. The main effect exerted by the association of the two enzymes is to decrease by about 10 kJ/mol the height of the energy barrier of the catalytic process. Phosphoribulokinase keeps an imprinting effect exerted by glyceraldehyde-3-phosphate dehydrogenase after the parting of the two enzymes. Part of the energy transferred from one protein to the other is used to decrease slightly the apparent binding free energy of the two substrates of phosphoribulokinase by about 1.5 kJ/mol. Whereas the previous association of the two enzymes does not significantly alter substrate binding to phosphoribulokinase, it greatly affects catalysis and decreases by about 16 kJ/mol the height of the energy barrier pertaining to this step. Therefore, within multienzyme complexes, information and energy can be transferred between proteins. Statistical thermodynamics offers the possibility of estimating how this energy is used to alter the various kinetic parameters of the reaction.


Assuntos
Chlamydomonas reinhardtii/enzimologia , Gliceraldeído-3-Fosfato Desidrogenases/química , Fosfotransferases (Aceptor do Grupo Álcool)/química , Termodinâmica , Animais , Cloroplastos/enzimologia , Gliceraldeído-3-Fosfato Desidrogenases/metabolismo , Cinética , Fosfotransferases (Aceptor do Grupo Álcool)/metabolismo , Conformação Proteica
10.
Eur J Biochem ; 250(2): 296-302, 1997 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-9428676

RESUMO

A mutant phosphoribulokinase has been isolated from the 12-2B mutant of Chlamydomonas reinhardtii. In this mutant, Arg64 has been replaced by Cys. The enzyme, which may exist in the dimeric and tetrameric states, is almost devoid of activity. Neither of these enzymes is able to form a complex with glyceraldehyde-3-phosphate dehydrogenase. The phosphoribulokinase gene has been expressed in Escherichia coli. The resulting recombinant protein, after isolation and purification, is apparently identical to the native enzyme extracted from the chloroplast. Three mutants have been generated by site directed mutagenesis. Arg64 has been replaced by Ala, Lys or Glu. With the exception of the latter, the two other mutants, [A64]phosphoribulokinase and [K64]phosphoribulokinase, are active when they are reduced, and nearly totally inactive in their oxidized state. Their activity, however, is decreased relative to that of the native, or to that of the wild-type recombinant phosphoribulokinase. Both the catalytic constant and the apparent affinity of ribulose 5-phosphate are decreased relative to the corresponding values obtained for the wild-type, the native or the recombinant enzyme. Whereas the [A64]phosphoribulokinase is unable to form a complex with glyceraldehyde-3-phosphate dehydrogenase, [K64]phosphoribulokinase does, but the stability of the resulting complex is much decreased relative to that of the wild-type complex. The oxidized mutant [K64]phosphoribulokinase becomes active in the presence of glyceraldehyde-3-phosphate dehydrogenase but this activity is smaller than that of the corresponding wild-type enzyme. Taken together, these results show that Arg64 plays a major role in the association of the two enzymes and in the information transfer that takes place between glyceraldehyde-3-phosphate dehydrogenase and phosphoribulokinase. As this residue also appears to be important for catalytic activity, it may be tempting to consider that it stabilizes a conformation that is required for both the catalytic activity and the formation of the bienzyme complex.


Assuntos
Chlamydomonas reinhardtii/enzimologia , Gliceraldeído-3-Fosfato Desidrogenases/química , Fosfotransferases (Aceptor do Grupo Álcool)/química , Animais , Arginina , Cloroplastos/enzimologia , Escherichia coli/genética , Gliceraldeído-3-Fosfato Desidrogenases/metabolismo , Cinética , Mutação , Fosfotransferases (Aceptor do Grupo Álcool)/metabolismo , Proteínas Recombinantes/química , Proteínas Recombinantes/metabolismo
11.
Braz J Med Biol Res ; 30(12): 1427-30, 1997 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-9686161

RESUMO

We cloned the streptokinase (STK) gene of Streptococcus equisimilis in an expression vector of Escherichia coli to overexpress the profibrinolytic protein under the control of a tac promoter. Almost all the recombinant STK was exported to the periplasmic space and recovered after gentle lysozyme digestion of induced cells. The periplasmic fraction was chromatographed on DEAE Sepharose followed by chromatography on phenyl-agarose. Active proteins eluted between 4.5 and 0% ammonium sulfate, when a linear gradient was applied. Three major STK derivatives of 47.5 kDa, 45 kDa and 32 kDa were detected by Western blot analysis with a polyclonal antibody. The 32-kDa protein formed a complex with human plasminogen but did not exhibit Glu-plasminogen activator activity, as revealed by a zymographic assay, whereas the 45-kDa protein showed a K(m) = 0.70 microM and kcat = 0.82 s-1, when assayed with a chromogen-coupled substrate. These results suggest that these proteins are putative fragments of STK, possibly derived from partial degradation during the export pathway or the purification steps. The 47.5-kDa band corresponded to the native STK, as revealed by peptide sequencing.


Assuntos
Clonagem Molecular , Escherichia coli , Proteínas Recombinantes , Streptococcus/genética , Estreptoquinase/genética , Estreptoquinase/isolamento & purificação
12.
Mol Biochem Parasitol ; 65(2): 225-32, 1994 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-7969264

RESUMO

NADP-malic enzyme II, one of two isoenzymes of NADP-malic enzyme (EC 1.1.1.40) in Trypanosoma cruzi epimastigotes, presents hysteretic behavior that results in a kinetic lag in the reaction progress curve. The lag is affected by the malate, aspartate and oxaloacetate concentrations in the assay mixture. This dependence suggests that hysteresis is due to an association-dissociation process influenced by the binding of these ligands to the enzyme. The enzyme was separated from NADP-malic enzyme I and purified 43-fold from a cell homogenate by a procedure involving column chromatography on DEAE-Sephacel and Cibacron-blue Sepharose. The molecular mass of the highly purified enzyme was determined as 126 kDa.


Assuntos
Malato Desidrogenase/análise , Trypanosoma cruzi/enzimologia , Animais , Citosol/enzimologia , Malato Desidrogenase/isolamento & purificação
13.
Mol Biochem Parasitol ; 30(2): 185-95, 1988 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-2845268

RESUMO

Highly purified preparations of plasma membranes from control and ketoconazole-treated (1 microM, 120 h) epimastigotes of Trypanosoma cruzi have been obtained by cell disruption using abrasion with glass beads, differential centrifugation and isopycnic centrifugation in continuous, self-generating Percoll gradients. The purity of the preparation was ascertained by the specific activity 125I bound to the membranes obtained from enzymatically radiolabeled epimastigotes and by the alpha-methyl-mannoside sensitive binding of 125I-concanavalin A. The membranes form closed vesicles of 0.2-0.4 micron in diameter which display Mg2+ ATPase and acid phosphatase activities, but are devoid of 5'-nucleotidase and succinate-cytochrome c oxidoreductase; these vesicles can be strongly agglutinated by concanavalin A. The lipid order profiles of membranes from control and treated cells were compared with that present in egg phosphatidylcholine/ergosterol liposomes (84:16, mol/mol) by electron spin resonance spectroscopy of doxylstearic acid probes with the nitroxide group bound to carbon 5, 10, 12 and 16 of the stearic acid chain. Membranes from treated epimastigotes have a lipid order profile which resembles that of control plasma membranes near the polar surface (positions 5 and 10) but there is an abrupt decrease of order at position 12 and from there to the center of bilayer is highly disordered, even more than in pure lipid membranes. Consistent with these results, the leakage of L-[14C]glucose from membrane vesicles of ketoconazole-treated cells is much faster than that observed in vesicles obtained from control cells. These results indicate a strong alteration of the plasma membrane physical and biological properties due to the incubation of the parasite with the drug; this alteration is consistent with the accumulation of methylated precursors of ergosterol, which affects both lipid-lipid and lipid-protein interactions in the membrane.


Assuntos
Cetoconazol/farmacologia , Bicamadas Lipídicas/metabolismo , Lipídeos de Membrana/metabolismo , Trypanosoma cruzi/metabolismo , Animais , Membrana Celular/efeitos dos fármacos , Membrana Celular/metabolismo , Permeabilidade da Membrana Celular , Centrifugação com Gradiente de Concentração , Centrifugação Isopícnica , Espectroscopia de Ressonância de Spin Eletrônica , Microscopia Eletrônica , Trypanosoma cruzi/efeitos dos fármacos , Trypanosoma cruzi/ultraestrutura
14.
Arch Inst Cardiol Mex ; 48(1): 214-32, 1978.
Artigo em Espanhol | MEDLINE | ID: mdl-666434

RESUMO

The results of a prospective study on the incidence of pulmonary thromboembolism and deep leg veins phlebitis in patients with congestive heart failure are presented. Pulmonary thromboembolism was diagnosed by means of pulmonary isotopic scanning and angiography; deep leg veins were studied using conventional and isotopic phlebography. A total incident of 60% for pulmonary thromboembolism and 92% for deep leg veins phlebitis was found, being of little significance the results suggested by clinical signs. ECG, chest X rays and laboratory tests such as arterial PO2, transaminase and lactic dehidrogenases. Among patients with pulmonary thromboembolism, the hospitalization periods were longer and more frequent, the incidence of deep leg veins phlebitis was 100%, mortality was slightly higher and the degree of hemodynamic derrangement was more advanced in patients without pulmonary thromboembolism. The rutinary use of pulmonary scanning and isotopic phlebography for detection of these complications in patients with congestive heart failure is recommended, emphasizing the need for prophylactic anticoagulant treatment in most of these patients.


Assuntos
Insuficiência Cardíaca/complicações , Perna (Membro)/irrigação sanguínea , Embolia Pulmonar/etiologia , Tromboflebite/etiologia , Insuficiência Cardíaca/mortalidade , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/mortalidade , Tromboflebite/diagnóstico , Tromboflebite/mortalidade
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