Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 21
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
Rev. bras. anestesiol ; 69(4): 335-341, July-Aug. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1042004

RESUMO

Abstract Introduction Malignant hyperthermia is an autosomal dominant pharmacogenetic disorder, characterized by hypermetabolic crisis triggered by halogenated anesthetics and/or succinylcholine. The standard method for diagnosing malignant hyperthermia susceptibility is the in vitro muscle contracture test in response to halothane-caffeine, which requires muscle biopsy under anesthesia. We describe a series of anesthetic procedures without triggering agents in malignant hyperthermia, comparing peripheral nerve block and subarachnoid anesthesia. Method We assessed the anesthetic record charts of 69 patients suspected of malignant hyperthermia susceptibility who underwent muscle biopsy for in vitro muscle contracture in the period of 7 years. Demographic data, indication for malignant hyperthermia investigation, in vitro muscle contracture test results, and surgery/anesthesia/recovery data were analyzed. Results Sample with 34 ± 13.7 years, 60.9% women, 65.2% of in vitro muscle contracture test positive. Techniques used: peripheral nerve blocks — lateral femoral and femoral cutaneous, latency 65 ± 41 min — (47.8%); subarachnoid anesthesia (49.3%), and total venous anesthesia (1.4%). There was 39.4% failure of peripheral nerve block and 11.8% of subarachnoid anesthesia. Adverse events (8.7%) occurred only with subarachnoid blockade (bradycardia, nausea, and transient neurological syndrome). All patients remained in the post-anesthesia care unit until discharge. Age and weight were significantly higher in patients with blockade failure (ROC cut-off point of 23.5 years and 59.5 kg) and blockade failure was more frequent in the presence of increased idiopathic creatine kinase. Conclusion Anesthesia with non-triggering agents has been shown to be safe in patients with malignant hyperthermia susceptibility. Variables such as age, weight, and history of increased idiopathic creatine kinase may be useful in selecting the anesthetic technique for this group of patients.


Resumo Introdução Hipertermia maligna é uma doença farmacogenética autossômica dominante, caracterizada por crise hipermetabólica desencadeada por anestésicos halogenados e/ou succinilcolina. O padrão para diagnóstico da suscetibilidade à hipertermia maligna é o teste de contratura muscular in vitro em resposta ao halotano-cafeína, para o qual é necessária biopsia muscular sob anestesia. Descrevemos uma série de anestesias sem agentes desencadeantes na hipertermia maligna e comparamos bloqueios de nervo periférico e anestesias subaracnóideas. Método Foram analisados os prontuários/fichas anestésicas de 69 pacientes suspeitos de susceptibilidade à hipertermia maligna, submetidos à biópsia muscular para teste de contratura muscular in vitro durante sete anos. Analisamos dados demográficos, indicação para investigação de hipertermia maligna, resultado do teste de contratura muscular in vitro e dados da cirurgia/anestesia/recuperação. Resultados Amostra com 34 ± 13,7 anos, 60,9% mulheres, 65,2% de teste de contratura muscular in vitro positivos. Técnicas empregadas: 47,8% bloqueios de nervo periférico (femoral e cutâneo femoral lateral, latência 65 ± 41 minutos), 49,3% anestesias subaracnóideas e 1,4% anestesia venosa total. Falha em 39,4% dos bloqueios de nervo periférico e 11,8% das anestesias subaracnóideas. Eventos adversos (8,7%) como bradicardia, náuseas e síndrome neurológica transitória só ocorreram com bloqueio subaracnóideo. Todos os pacientes permaneceram na sala de recuperação pós-anestésica até liberação. Idade e peso foram significativamente maiores nos pacientes com falha no bloqueio (ponto de corte da curva ROC de 23,5 anos e 59,5 Kg) e esta foi mais frequente na presença de aumento idiopático de creatinoquinase. Conclusão Anestesia com agentes não desencadeantes mostrou-se segura em pacientes suscetíveis à hipertermia maligna. Variáveis como idade, peso e antecedente de aumento idiopático de creatinoquinase podem ser úteis para selecionar a técnica anestésica nesse grupo.

2.
J Bras Nefrol ; 39(3): 239-245, 2017.
Artigo em Inglês, Português | MEDLINE | ID: mdl-28902231

RESUMO

INTRODUCTION: The incidence of chronic kidney disease (CKD) is increasing with the increasing age of the population and the increasing number of elderly survivors of acute kidney injury (AKI). The risk factors for the progression of CKD after AKI are unclear. OBJECTIVE: To investigate the association between AKI and its progression to CKD and the risk factors involved. METHODS: An observational, retrospective study of AKI patients followed from 2009 to 2012 was carried out. We evaluated the etiology of AKI, the use of vasoactive drugs and mechanical ventilation, the need for dialysis, the presence of comorbidities, the glomerular filtration rate (GFR), the length of stay and the progression of CKD. Statistical analyses, including the Chi-square test and Pearson's correlation, were performed using SPSS. RESULTS: The 207 patients analyzed had a mean age of 70.1 ± 13.1, and 84.6% of the male patients exhibited decreased renal function and CKD (vs. 60.4% of the female patients). The progression of AKI to CKD was more frequent in patients admitted to wards (63.8%), cancer patients (74.19%), patients with sepsis (67.18%) and patients with obstruction (91.66%). Dialyses were performed in 16.4% of the patients, but this was not correlated with the progression of CKD. CONCLUSIONS: Being an elderly male patient with AKI due to sepsis and obstruction was correlated with progression to CKD following discharge.


Assuntos
Lesão Renal Aguda/complicações , Insuficiência Renal Crônica/etiologia , Idoso , Progressão da Doença , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco
3.
J. bras. nefrol ; 39(3): 239-245, July-Sept. 2017. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-893781

RESUMO

Abstract Introduction: The incidence of chronic kidney disease (CKD) is increasing with the increasing age of the population and the increasing number of elderly survivors of acute kidney injury (AKI). The risk factors for the progression of CKD after AKI are unclear. Objective: To investigate the association between AKI and its progression to CKD and the risk factors involved. Methods: An observational, retrospective study of AKI patients followed from 2009 to 2012 was carried out. We evaluated the etiology of AKI, the use of vasoactive drugs and mechanical ventilation, the need for dialysis, the presence of comorbidities, the glomerular filtration rate (GFR), the length of stay and the progression of CKD. Statistical analyses, including the Chi-square test and Pearson's correlation, were performed using SPSS. Results: The 207 patients analyzed had a mean age of 70.1 ± 13.1, and 84.6% of the male patients exhibited decreased renal function and CKD (vs. 60.4% of the female patients). The progression of AKI to CKD was more frequent in patients admitted to wards (63.8%), cancer patients (74.19%), patients with sepsis (67.18%) and patients with obstruction (91.66%). Dialyses were performed in 16.4% of the patients, but this was not correlated with the progression of CKD. Conclusions: Being an elderly male patient with AKI due to sepsis and obstruction was correlated with progression to CKD following discharge.


Resumo Introdução: A incidência da doença renal crônica (DRC) está aumentando com o aumento da idade da população e o número crescente de idosos sobreviventes da lesão renal aguda (LRA). Os fatores de risco para a progressão da DRC após a lesão renal aguda (LRA) não são claros. Objetivos: Investigar a associação entre a LRA e sua progressão para a DRC e os fatores de risco envolvidos. Métodos: Foi realizado estudo observacional, retrospectivo de pacientes com LRA acompanhados de 2009 a 2012. Foram avaliados a etiologia da LRA, o uso de drogas vasoativas, ventilação mecânica, necessidade de diálise, presença de morbidades associadas, ritmo de filtração glomerular estimado (eGFR), duração da internação e a progressão da DRC. As análises estatísticas incluíram o teste Qui-quadrado e a correlação de Pearson utilizando o programa do SPSS. Resultados: Os 207 pacientes analisados apresentaram idade de 70,1 ± 13,1 anos, 84,6% eram do sexo masculino e que apresentaram redução da função renal e DRC (vs. 60,4% dos pacientes do sexo feminino). A progressão da LRA para DRC foi mais frequente em pacientes internados em enfermarias (63,8%), pacientes com câncer (74,19%), com sepse (67,18%) e com obstrução do trato urinário (91,66%). As dialises foram realizadas em 16,4% dos pacientes, mas isso não foi correlacionado com a progressão da DRC. Conclusões: Pacientes idosos com LRA devido à sepse e obstrução do trato urinário foram correlacionados com a progressão para DRC após a alta.

4.
Arq Neuropsiquiatr ; 75(8): 515-522, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28813081

RESUMO

Objective: To investigate the impact of epidemiological and clinical factors on the benefit of riluzole in patients with amyotrophic lateral sclerosis (ALS). Methods: The survival rate of 578 patients with ALS (1999-2011) was analyzed by descriptive statistics and Kaplan-Meier curves. Considering the median of the sample survival time (19 months), patients were divided in two groups: below (B19) and above the median (A19). Kaplan-Meier curves compared the survival rates of patients treated with riluzole and with patients who did not take the medication. Results: Riluzole increased the survival rates of patients with lower limb onset who were diagnosed after the first appointment in B19. Patients with bulbar onset and diagnosed on the first, or after the first appointment showed higher survival rates in A19. Males lived longer than females in both groups. Conclusion: Epidemiological and clinical factors influenced the benefit of riluzole in the survival rates of patients with ALS.


Assuntos
Esclerose Amiotrófica Lateral/tratamento farmacológico , Esclerose Amiotrófica Lateral/mortalidade , Fármacos Neuroprotetores/uso terapêutico , Riluzol/uso terapêutico , Esclerose Amiotrófica Lateral/diagnóstico , Brasil/epidemiologia , Paralisia Bulbar Progressiva/diagnóstico , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores Sexuais , Taxa de Sobrevida
5.
Arq. neuropsiquiatr ; 75(8): 515-522, Aug. 2017. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-888317

RESUMO

ABSTRACT Objective To investigate the impact of epidemiological and clinical factors on the benefit of riluzole in patients with amyotrophic lateral sclerosis (ALS). Methods The survival rate of 578 patients with ALS (1999-2011) was analyzed by descriptive statistics and Kaplan-Meier curves. Considering the median of the sample survival time (19 months), patients were divided in two groups: below (B19) and above the median (A19). Kaplan-Meier curves compared the survival rates of patients treated with riluzole and with patients who did not take the medication. Results Riluzole increased the survival rates of patients with lower limb onset who were diagnosed after the first appointment in B19. Patients with bulbar onset and diagnosed on the first, or after the first appointment showed higher survival rates in A19. Males lived longer than females in both groups. Conclusion Epidemiological and clinical factors influenced the benefit of riluzole in the survival rates of patients with ALS.


RESUMO Objetivo Investigar o impacto de fatores epidemiológicos e clínicos sobre o benefício do riluzole em pacientes com esclerose lateral amiotrófica (ELA). Métodos A sobrevida de 578 pacientes com ELA (1999-2011) foi analisada por estatística descritiva e curvas de Kaplan-Meier. Considerando a mediana do tempo de sobrevida (19 meses), a amostra foi subdividida em dois grupos: sobrevida abaixo (B19) e acima de 19 meses (A19). As curvas de Kaplan-Meier compararam a sobrevida de pacientes tratados com riluzole e com pacientes que não receberam tratamento. Resultados O riluzole aumentou a sobrevida de pacientes com início nos membros inferiores e diagnosticados após a primeira consulta no grupo B19. Pacientes com início bulbar e diagnosticados na primeira/ após a primeira consulta apresentaram maior sobrevida em A19. Os homens apresentaram sobrevida maior do que as mulheres. Conclusão Foram encontradas diferenças epidemiológicas e clínicas no benefício do riluzole em pacientes com ELA.

6.
Arq Neuropsiquiatr ; 75(7): 451-456, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28746432

RESUMO

Late onset multiple sclerosis (LOMS) is when the first symptom starts after 50 years of age, representing 4.5% of multiple sclerosis (MS) patients. This study describes the clinical characteristics of patients with LOMS followed at a specialized MS center in São Paulo. Data was obtained from medical records of 742 patients with MS. The LOMS frequency was 4.18%, median age at onset was 54 years and the predominant disease course was primary progressive (64.3%). The patients reached the disability landmarks of EDSS grades 3.0, 6.0 and 7.0 in the following proportion and time: EDSS 3.0: 77.42% of patients in 3.7 years; EDSS 6.0: 58.06% in 5.1 years and EDSS 7.0: 32.26% in 5.7 years. The comparative analysis with a matched control group of patients with early onset MS showed that late onset, associated with a progressive course, were predictors of reaching EDSS 3.0 and 6.0 in a shorter time.


Assuntos
Esclerose Múltipla/epidemiologia , Idade de Início , Brasil/epidemiologia , Avaliação da Deficiência , Progressão da Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade
7.
Arq. neuropsiquiatr ; 75(7): 451-456, July 2017. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-888294

RESUMO

ABSTRACT Late onset multiple sclerosis (LOMS) is when the first symptom starts after 50 years of age, representing 4.5% of multiple sclerosis (MS) patients. This study describes the clinical characteristics of patients with LOMS followed at a specialized MS center in São Paulo. Data was obtained from medical records of 742 patients with MS. The LOMS frequency was 4.18%, median age at onset was 54 years and the predominant disease course was primary progressive (64.3%). The patients reached the disability landmarks of EDSS grades 3.0, 6.0 and 7.0 in the following proportion and time: EDSS 3.0: 77.42% of patients in 3.7 years; EDSS 6.0: 58.06% in 5.1 years and EDSS 7.0: 32.26% in 5.7 years. The comparative analysis with a matched control group of patients with early onset MS showed that late onset, associated with a progressive course, were predictors of reaching EDSS 3.0 and 6.0 in a shorter time.


RESUMO Esclerose múltipla de inicio tardio (EMIT) caracteriza-se pelo início de sintomas aos 50 ou mais anos de idade, representando 4,5% dos pacientes com esclerose múltipla (EM). Este estudo descreve as características clínicas de pacientes com EMIT acompanhados num centro de EM em São Paulo. Dados foram obtidos através de análise de prontuário de 742 pacientes com EM. A frequência de EMIT foi de 4,18%, a mediana da idade de início foi de 54 anos e a forma clínica predominante a primariamente progressiva (64,3%). Os pacientes atingiram os marcos de incapacidade EDSS 3, 6 e 7 nas respectivas proporções e tempo: EDSS 3.0, 77,42% de pacientes em 3.7 anos; EDSS 6.0, 58,06% em 5.1 anos e EDSS 7.0, 32,26% em 5.7 anos. A análise comparativa a um grupo controle de jovens com EM, mostrou que o início tardio associado a forma primariamente progressiva foram preditores para atingir EDSS 3 e 6 num período menor.

8.
Clinics (Sao Paulo) ; 72(3): 171-177, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28355363

RESUMO

OBJECTIVE:: To evaluate the respiratory systems of male and female rats maintained in individually ventilated cages (IVCs) from birth until adulthood. METHODS:: Female Wistar rats were housed in individually ventilated cages or conventional cages (CCs) and mated with male Wistar rats. After birth and weaning, the male offspring were separated from the females and kept in cages of the same type until 12 weeks of age. RESULTS:: The level of food consumption was lower in male offspring (IVC=171.7±9; CC=193.1±20) than in female offspring (IVC=100.6±7; CC=123.4±0.4), whereas the water intake was higher in female offspring (IVC=149.8±11; CC=99.2±0) than in male offspring (IVC=302.5±25; CC=249.7±22) at 11 weeks of age when housed in IVCs. The cage temperature was higher in individually ventilated cages than in conventional cages for both male (IVCs=25.9±0.5; CCs=22.95±0.3) and female (IVCs=26.2±0.3; CCs=23.1±0.3) offspring. The respiratory resistance (IVC=68.8±2.8; CC=50.6±3.0) and elastance (IVC=42.0±3.9; CC=32.4±2.0) at 300 µm/kg were higher in the female offspring housed in ventilated cages. The ciliary beat values were lower in both the male (IVCs=13.4±0.2; CC=15±0.4) and female (IVC=13.5±0.4; CC=15.9±0.6) offspring housed in individually ventilated cages than in those housed in conventional cages. The total cell (IVC=117.5±9.7; CC=285.0±22.8), neutrophil (IVC=13.1±4.8; CC=75.6±4.1) and macrophage (IVC=95.2±11.8; CC=170.0±18.8) counts in the bronchoalveolar lavage fluid were lower in the female offspring housed in individually ventilated cages than in those housed in conventional cages. CONCLUSIONS:: The environmental conditions that exist in individually ventilated cages should be considered when interpreting the results of studies involving laboratory animals. In this study, we observed gender dimorphism in both the water consumption and respiratory mechanics of rats kept in ventilated cages.


Assuntos
Abrigo para Animais/normas , Modelos Animais , Fenômenos Fisiológicos Respiratórios , Ventilação , Fatores Etários , Bem-Estar do Animal , Animais , Pressão Sanguínea/fisiologia , Líquido da Lavagem Broncoalveolar , Ingestão de Alimentos/fisiologia , Planejamento Ambiental , Feminino , Frequência Cardíaca/fisiologia , Masculino , Ratos Wistar , Testes de Função Respiratória , Fatores Sexuais , Temperatura Ambiente , Fatores de Tempo
9.
Clinics ; 72(3): 171-177, Mar. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-840050

RESUMO

OBJECTIVE: To evaluate the respiratory systems of male and female rats maintained in individually ventilated cages (IVCs) from birth until adulthood. METHODS: Female Wistar rats were housed in individually ventilated cages or conventional cages (CCs) and mated with male Wistar rats. After birth and weaning, the male offspring were separated from the females and kept in cages of the same type until 12 weeks of age. RESULTS: The level of food consumption was lower in male offspring (IVC=171.7±9; CC=193.1±20) than in female offspring (IVC=100.6±7; CC=123.4±0.4), whereas the water intake was higher in female offspring (IVC=149.8±11; CC=99.2±0) than in male offspring (IVC=302.5±25; CC=249.7±22) at 11 weeks of age when housed in IVCs. The cage temperature was higher in individually ventilated cages than in conventional cages for both male (IVCs=25.9±0.5; CCs=22.95±0.3) and female (IVCs=26.2±0.3; CCs=23.1±0.3) offspring. The respiratory resistance (IVC=68.8±2.8; CC=50.6±3.0) and elastance (IVC=42.0±3.9; CC=32.4±2.0) at 300 µm/kg were higher in the female offspring housed in ventilated cages. The ciliary beat values were lower in both the male (IVCs=13.4±0.2; CC=15±0.4) and female (IVC=13.5±0.4; CC=15.9±0.6) offspring housed in individually ventilated cages than in those housed in conventional cages. The total cell (IVC=117.5±9.7; CC=285.0±22.8), neutrophil (IVC=13.1±4.8; CC=75.6±4.1) and macrophage (IVC=95.2±11.8; CC=170.0±18.8) counts in the bronchoalveolar lavage fluid were lower in the female offspring housed in individually ventilated cages than in those housed in conventional cages. CONCLUSIONS: The environmental conditions that exist in individually ventilated cages should be considered when interpreting the results of studies involving laboratory animals. In this study, we observed gender dimorphism in both the water consumption and respiratory mechanics of rats kept in ventilated cages.


Assuntos
Animais , Masculino , Feminino , Abrigo para Animais/normas , Modelos Animais , Fenômenos Fisiológicos Respiratórios , Ventilação , Fatores Etários , Bem-Estar do Animal , Pressão Sanguínea/fisiologia , Líquido da Lavagem Broncoalveolar , Ingestão de Alimentos/fisiologia , Planejamento Ambiental , Frequência Cardíaca/fisiologia , Ratos Wistar , Testes de Função Respiratória , Fatores Sexuais , Temperatura Ambiente , Fatores de Tempo
10.
Rev. Soc. Bras. Clín. Méd ; 14(4): 190-194, 2016.
Artigo em Português | LILACS | ID: biblio-827211

RESUMO

Objetivo: Caracterizar os fatores de risco para lesão renal aguda em pacientes submetidos a cirurgias não cardíacas na unidade de terapia intensiva e sua influência na evolução clínica no pós-operatório. Métodos: Estudo clínico, prospectivo, observacional com 98 pacientes na unidade de terapia intensiva de pós-operatório do Hospital Servidor Público Estadual entre novembro de 2012 e fevereiro de 2013. As variáveis estudadas foram idade, sexo, risco pré-operatório, tipo de cirurgia e anestesia, comorbidades, necessidade de ventilação mecânica, drogas vasoativas, transfusão, diálise e sobrevida em 30 dias. O diagnóstico da lesão renal aguda foi estabelecido pelos critérios Acute Kidney Injury Network (AKIN). Na análise estatística, variáveis categóricas foram avaliadas pelo teste qui quadrado e níveis de p<0,05 foram considerados significantes. Resultados: Os pacientes apresentavam idade de 70,7±13,8 anos, 57,1% eram do sexo masculino e 88,8% estavam em pós-operatório de cirurgia eletiva. Desenvolveram lesão renal aguda 35 (35,7%) pacientes e, destes, 20 (59,2%) eram AKIN 1, (3) 8,6% AKIN 2 e 12 (34,2%) AKIN 3. Necessitaram de diálise 24 (68,57%) pacientes. Risco anestésico elevado nas cirurgias eletivas, intercorrências no intraoperatório e presença da doença renal crônica foram fatores que influenciaram no aparecimento da lesão renal aguda especialmente nos idosos. A mortalidade nos pacientes com lesão renal aguda foi 46% vs. 11% daqueles sem lesão renal aguda. Conclusão: A lesão renal aguda apresentou alta mortalidade em idosos submetidos à cirurgia eletiva com risco pré-operatório elevado e doença renal crônica prévia. É importante a identificação precoce destes fatores de risco e da lesão renal aguda nesses pacientes.


Objectives: To characterize risk factors for acute kidney injury in patients undergoing non-cardiac surgeries in Intensive Care Unit (ICU), and their influence on clinical outcomes postoperatively. Methods: Clinical, prospective, observational study of 98 patients admitted to the Intensive Care Unit after surgery at Hospital do Servidor Público Estadual from November/2012 to February/2013. The variables studied were: age, gender, preoperative anesthetic risk, type of surgery and anesthesia, comorbidities, need for mechanical ventilation, use of vasoactive drugs, need for blood transfusion, renal replacement therapy (RRT) and survival at 30 days. The diagnosis of acute kidney injury has been established through the Acute Kidney Injury Network (AKIN) criteria. At statistical analysis, categorical variables were analyzed using the chi-square test and p levels <0.05 were considered significant. Results: Patients were 70.7 ± 13.8 years old; 57.1% were male, and 88.8% were in postoperative period of elective surgery. Thirty-five patients (35.7%) had an acute kidney injury, with 20 (59.2%) being AKIN1, 8.6% AKIN2 (3), and 12 (34.2%) AKIN3. High anesthetic risk in elective surgeries, complications during surgery, and the presence of chronic kidney disease were factors that influenced the onset of acute kidney injury, especially in the elderly. Mortality in patients with acute kidney injury was of 46%, versus 11% of those without acute kidney injury. Conclusion: Acute kidney injury showed high mortality in the elderly patients undergoing elective surgery with a high preoperative risk and previous chronic kidney disease. The early identification of these risk factors, as well as the early diagnosis of acute kidney injury in these patients is important.


Assuntos
Humanos , Masculino , Feminino , Idoso , Lesão Renal Aguda/cirurgia , Complicações Pós-Operatórias , Insuficiência Renal Crônica/complicações , Unidades de Terapia Intensiva , Complicações Intraoperatórias , Fatores de Risco , Procedimentos Cirúrgicos Operatórios
11.
MedicalExpress (São Paulo, Online) ; 2(5)Sept.-Oct. 2015. graf
Artigo em Inglês | LILACS | ID: lil-776669

RESUMO

INTRODUCTION: Astrocytomas are common brain tumors. Increased expression levels of Interleukin-13 Receptor α2 (IL-13RA2) have been reported in astrocytomas. The Interleukin-13 signaling pathway may be associated with cell migration when binding to Interleukin-13 Receptor α1. OBJECTIVE: To investigate Interleukin-13 Receptor α1 (IL-13RA1) and IL13RA2 expression levels in human diffusely infiltrative astrocytomas and test the involvement of Interleukin-13 levels in cell migration in two glioblastoma cell lines. METHODS: IL13RA expression levels were accessed by quantitative real time PCR in 128 samples of astrocytomas and 18 samples of non-neoplastic brain tissues from temporal lobe epilepsy surgery. The impact of IL-13 levels (10 and 20 ng/mL) on cell migration was analyzed by the wound assay in U87MG and A172 cells. RESULTS: Glioblastoma presented higher IL13RA1 and IL13RA2 expression levels compared to lower grades astrocytomas and to non-neoplastic cases. U87MG and A172 cells presented higher expression levels of IL-13RA1 vs. IL-13RA2. A significant difference in migration rate was observed in A172 cells treated with 10 ng/mL of IL-13 vs. control: treated cells presented slower migration than non-treated cells. U87MG cells treated with IL-13 20ng/mL presented slower migration than non-treated cells. This indicates that the IL13Rα1 signaling pathway was not activated, indeed inhibited by the decoy IL-13Rα2, slowing cell migration. This impact occurred with a lesser concentration of IL-13 on the A172 than on the U87MG cell line, because A172 cells have a higher IL-13RA2/A1 ratio. CONCLUSION: The present results suggest IL-13 receptors as possible targets to decrease tumor cell migration.


INTRODUÇÃO Astrocitomas são os tumores cerebrais mais frequentes. Nestes tumores foi observada maior expressão do receptor de Interleucina-13 α2 (IL13RA2). A cascata de sinalização da Interleucina-13 pode estar associada com a migração celular, após sua ligação com o receptor de Interleucina-13 α1 (IL13Rα1). OBJETIVO: Investigar os níveis de expressão dos receptores de Interleucina-13 (IL13RA1 e IL13RA2) em astrocitomas difusamente infiltrativos e avaliar o envolvimento da Interleucina-13 na migração celular de duas linhagens de glioblastoma. MÉTODOS: A expressão dos receptores IL13RA foi analisada por PCR em tempo real, em 128 amostras de astrocitomas e 18 amostras de tecido cerebral não neoplásico, provenientes de cirurgia de epilepsia do lobo temporal. E o impacto da quantidade de IL-13 (10ng/ml e 20ng/ml) em ensaio de migração celular. RESULTADOS: As amostras de Glioblastoma apresentaram maior expressão de IL13RA1 and IL13RA2 comparados com astrocitomas de baixo grau e os casos não-neoplásicos. Nas células U87MG e A172 foi observado maior nível de expressão de IL-13RA1 do que IL-13RA2. Uma diferença significativa na taxa de migração foi obtida em células A172 tratadas com 10 ng/mL comparadas com o controle: as células tratadas apresentaram menor migração que as células não tratadas. As células U87MG tratadas com 20ng/mL de IL-13 apresentaram menor migração celular que as células não tratadas. A diferença na migração celular indica que o caminho de sinalização de IL13Rα1 não foi ativado e foi inibido pelo IL-13Rα2, diminuindo a migração celular. Esse impacto ocorreu com uma concentração menor de IL-13 nas células A172 ao contrário da U87MG, porque as células A172 possuem uma razão IL-13RA2/A1 maior. CONCLUSÃO: os resultados sugerem que os receptores de IL-13 podem ser utilizados como possíveis alvos para a diminuição da migração celular tumoral.


Assuntos
Humanos , Astrocitoma , Neoplasias Encefálicas , Movimento Celular/efeitos dos fármacos , Interleucina-13/administração & dosagem , Receptores de Interleucina-13/administração & dosagem
12.
J Neurol Sci ; 355(1-2): 189-92, 2015 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-26076879

RESUMO

OBJECTIVE: Evaluate the correlation between spinal cord lesion length and pyramidal function system score in a cohort of patients with NMO. METHODOLOGY: Retrospective retrieval of all exams performed in our center from January 2004 to December 2012 for patients with NMO. The exams were evaluated for lesion length, contrast enhancement and T1 hypointensity; these variables were correlated with the functional system score from the EDSS, performed no more than three months from the scan. RESULTS: 41 patients were included. Although patients with lesion extension ≥2 vertebral segments did not present worse pyramidal scores in a direct comparison, the influence of lesion length was not so strong when patients were separated in 3 groups (≥2, ≥3 or ≥4 vertebral segments) and evaluated with a receiving operating characteristics (ROC) curves. Gadolinium enhancement also contributed to more severe pyramidal system scores, but T1 hypointensity did not. CONCLUSION: Although patients with spinal cord lesion extending ≥3 vertebral segments had more pyramidal disability, its difference was not so strong when compared to patients with ≥2 or ≥4 vertebral segments. This suggests that lesion extension might not be the most important factor in favoring a worse prognosis in spinal cord lesions in NMO.


Assuntos
Neuromielite Óptica/complicações , Tratos Piramidais/patologia , Doenças da Medula Espinal/etiologia , Adulto , Estudos de Coortes , Avaliação da Deficiência , Feminino , Humanos , Imunoglobulina G/sangue , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Curva ROC , Doenças da Medula Espinal/diagnóstico , Adulto Jovem
13.
Clinics (Sao Paulo) ; 68(6): 760-5, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23778473

RESUMO

OBJECTIVES: Chronic kidney disease is a major public health problem worldwide. In Brazil, approximately 100,000 patients (January 2012) receive renal replacement therapy. Nevertheless, data on dialysis incidence in the Brazilian population are scarce. This study aims to analyze the incidence of patients starting dialysis therapy in São Paulo City, the largest Brazilian metropolis. METHOD: This cohort study analyzed data from 9,994 patients starting hemodialysis or peritoneal dialysis funded by the Brazilian Public Health System during a 5-year period (2007-2011). Patient data for this study (recorded as electronic files) were obtained from the São Paulo City's Dialysis Regulatory Bureau, which regulates the allocation of patients requiring dialytic therapy. RESULTS: The dialysis incidence rates were 178, 174, 170, 185 and 188 per million population for the years 2007, 2008, 2009, 2010 and 2011, respectively. The incidence rates increased with age. Hypertension and diabetes were the main etiologies diagnosed. Hemodialysis was the chosen dialysis modality in the majority of patients (92.6%), whereas the percentage of patients referred for peritoneal dialysis decreased from 10.1% to 5.5%. CONCLUSION: The incidence of patients starting renal replacement therapy from 2007-2011 in São Paulo was stable but higher than the projected incidence for the entire country. The authors emphasize the need for further studies of the incidence of dialysis in the Brazilian population and for the creation of a Brazilian registry of dialysis patients, which would be a valuable tool for developing healthcare policies and renal replacement therapy strategies.


Assuntos
Diálise Renal/estatística & dados numéricos , Insuficiência Renal Crônica/epidemiologia , Distribuição por Idade , Fatores Etários , Idoso , Brasil/epidemiologia , Cidades/epidemiologia , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/terapia , Distribuição por Sexo , Fatores de Tempo
14.
Clinics ; 68(6): 760-765, jun. 2013. tab, graf
Artigo em Inglês | LILACS | ID: lil-676927

RESUMO

OBJECTIVES: Chronic kidney disease is a major public health problem worldwide. In Brazil, approximately 100,000 patients (January 2012) receive renal replacement therapy. Nevertheless, data on dialysis incidence in the Brazilian population are scarce. This study aims to analyze the incidence of patients starting dialysis therapy in São Paulo City, the largest Brazilian metropolis. METHOD: This cohort study analyzed data from 9,994 patients starting hemodialysis or peritoneal dialysis funded by the Brazilian Public Health System during a 5-year period (2007-2011). Patient data for this study (recorded as electronic files) were obtained from the São Paulo City's Dialysis Regulatory Bureau, which regulates the allocation of patients requiring dialytic therapy. RESULTS: The dialysis incidence rates were 178, 174, 170, 185 and 188 per million population for the years 2007, 2008, 2009, 2010 and 2011, respectively. The incidence rates increased with age. Hypertension and diabetes were the main etiologies diagnosed. Hemodialysis was the chosen dialysis modality in the majority of patients (92.6%), whereas the percentage of patients referred for peritoneal dialysis decreased from 10.1% to 5.5%. CONCLUSION: The incidence of patients starting renal replacement therapy from 2007-2011 in São Paulo was stable but higher than the projected incidence for the entire country. The authors emphasize the need for further studies of the incidence of dialysis in the Brazilian population and for the creation of a Brazilian registry of dialysis patients, which would be a valuable tool for developing healthcare policies and renal replacement therapy strategies. .


Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diálise Renal , Insuficiência Renal Crônica/epidemiologia , Distribuição por Idade , Fatores Etários , Brasil/epidemiologia , Estudos de Coortes , Cidades/epidemiologia , Incidência , Diálise Renal/estatística & dados numéricos , Insuficiência Renal Crônica/terapia , Distribuição por Sexo , Fatores de Tempo
15.
Arq. bras. cardiol ; 100(5): 404-411, maio 2013. ilus, tab
Artigo em Português | LILACS | ID: lil-675601

RESUMO

FUNDAMENTO: Hiperglicemia na fase aguda do infarto do miocárdio é importante fator prognóstico. Entretanto, sua fisiopatologia não está completamente elucidada. OBJETIVO: Analisar simultaneamente correlação entre hiperglicemia e marcadores bioquímicos relacionados ao estresse,metabolismo glicídico e lipídico, coagulação, inflamação e necrose miocárdica. MÉTODOS: Oitenta pacientes com infarto agudo do miocárdio foram incluídos prospectivamente. Os parâmetros analisados foram: glicose, hormônios do estresse (cortisol e norepinefrina), fatores do metabolismo glicídico [hemoglobina glicada (HbA1c), insulina], lipoproteínas (colesterol total, LDL, HDL, LDL eletronegativa minimamente modificada e adiponectina), glicerídeos (triglicérides, VLDL e ácido graxo), fatores da coagulação (fator VII, fibrinogênio,inibidor do ativador do plasminogênio-1), inflamação (proteína C reativa ultrassensível) e necrose miocárdica (CK-MB e troponina). Variáveis contínuas foram convertidas em graus de pertinência por intermédio de lógica fuzzy. RESULTADOS: Houve correlação significativa entre hiperglicemia e metabolismo glicídico (p < 0,001), lipoproteínas (p = 0,03) e fatores de necrose (p = 0,03). Na análise multivariada, somente metabolismo glicídico (OR = 4,3; IC = 2,1-68,9 e p < 0,001) e necrose miocárdica (OR = 22,5; IC = 2-253 e p = 0,012) mantiveram correlação independente e significativa.Para análise da influência da história de diabetes mellitus , modelo de regressão, incluindo somente pacientes sem diabetes mellitus foi desenvolvido, e os resultados não alteraram. Finalmente, no modelo ajustado para idade, sexo e variáveis clínicas(história de diabetes mellitus, hipertensão arterial e dislipidemia), três variáveis mantiveram associação significativa e independente com hiperglicemia: metabolismo glicídico (OR = 24,1; IC = 4,8-122,1 e p < 0,001) necrose miocárdica (OR = 21,9; IC = 1,3-360,9 e p = 0,03) e história de DM (OR = 27, IC = 3,7-195,7 e p = 0,001). CONCLUSÃO: Marcadores do metabolismo glicídico e necrose miocárdica foram os melhores preditores de hiperglicemia em pacientes com infarto agudo do miocárdio.


BACKGROUND: Hyperglycemia in the acute phase of myocardial infarction is an important prognostic factor. However, its pathophysiology is not fully understood. OBJECTIVE: To analyze simultaneously the correlation between hyperglycemia and biochemical markers related to stress, glucose and lipid metabolism, coagulation, inflammation, and myocardial necrosis. METHODS Eighty patients with acute myocardial infarction were prospectively included. The following parameters were analyzed: blood glucose; stress hormones (cortisol and norepinephrine); glucose metabolism factors [glycated hemoglobin (HbA1c); insulin]; lipoproteins (total cholesterol, LDL, HDL, minimally modified electronegative LDL, and adiponectin); glycerides (triglycerides, VLDL and fatty acids); coagulation factors (factor VII, fibrinogen, plasminogen activator inhibitor-1); inflammation (high-sensitivity C reactive protein); and myocardial necrosis (CK-MB and troponin). Continuous variables were converted into degrees of relevance using fuzzy logic. RESULTS: Significant correlation was observed between hyperglycemia and glucose metabolism (p < 0.001), lipoproteins (p = 0.03), and necrosis factors (p = 0.03). In the multivariate analysis, only glucose metabolism (OR = 4.3; CI = 2.1-68.9; and p < 0.001) and myocardial necrosis (OR = 22.5; CI = 2-253; and p = 0.012) showed independent and significant correlation. For the analysis of the influence of history of diabetes mellitus, a regression model including only patients without diabetes mellitus was developed, and the results did not change. Finally, in the model adjusted for age, gender, and clinical variables (history of diabetes mellitus, hypertension and dyslipidemia), three variables maintained a significant and independent association with hyperglycemia: glucose metabolism (OR = 24.1; CI = 4.8-122.1; and p < 0.001), myocardial necrosis (OR = 21.9; CI = 1.3-360.9; and p = 0.03), and history of DM (OR = 27; CI = 3.7-195.7; and p = 0.001). CONCLUSION: Glucose metabolism and myocardial necrosis markers were the best predictors of hyperglycemia in patients with acute myocardial infarction.


Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diabetes Mellitus/diagnóstico , Hiperglicemia/diagnóstico , Infarto do Miocárdio/sangue , Troponina/sangue , Biomarcadores/sangue , Coagulação Sanguínea/fisiologia , Creatina Quinase Forma MB/sangue , Diabetes Mellitus/sangue , Métodos Epidemiológicos , Hemoglobina A Glicada/análise , Hiperglicemia/sangue , Inflamação/sangue , Insulina/sangue , Lipoproteínas/sangue , Infarto do Miocárdio/patologia , Necrose , Estresse Fisiológico/fisiologia
16.
Arq Bras Cardiol ; 100(5): 404-11, 2013 May.
Artigo em Inglês, Português | MEDLINE | ID: mdl-23598457

RESUMO

BACKGROUND: Hyperglycemia in the acute phase of myocardial infarction is an important prognostic factor. However, its pathophysiology is not fully understood. OBJECTIVE: To analyze simultaneously the correlation between hyperglycemia and biochemical markers related to stress, glucose and lipid metabolism, coagulation, inflammation, and myocardial necrosis. METHODS Eighty patients with acute myocardial infarction were prospectively included. The following parameters were analyzed: blood glucose; stress hormones (cortisol and norepinephrine); glucose metabolism factors [glycated hemoglobin (HbA1c); insulin]; lipoproteins (total cholesterol, LDL, HDL, minimally modified electronegative LDL, and adiponectin); glycerides (triglycerides, VLDL and fatty acids); coagulation factors (factor VII, fibrinogen, plasminogen activator inhibitor-1); inflammation (high-sensitivity C reactive protein); and myocardial necrosis (CK-MB and troponin). Continuous variables were converted into degrees of relevance using fuzzy logic. RESULTS: Significant correlation was observed between hyperglycemia and glucose metabolism (p < 0.001), lipoproteins (p = 0.03), and necrosis factors (p = 0.03). In the multivariate analysis, only glucose metabolism (OR = 4.3; CI = 2.1-68.9; and p < 0.001) and myocardial necrosis (OR = 22.5; CI = 2-253; and p = 0.012) showed independent and significant correlation. For the analysis of the influence of history of diabetes mellitus, a regression model including only patients without diabetes mellitus was developed, and the results did not change. Finally, in the model adjusted for age, gender, and clinical variables (history of diabetes mellitus, hypertension and dyslipidemia), three variables maintained a significant and independent association with hyperglycemia: glucose metabolism (OR = 24.1; CI = 4.8-122.1; and p < 0.001), myocardial necrosis (OR = 21.9; CI = 1.3-360.9; and p = 0.03), and history of DM (OR = 27; CI = 3.7-195.7; and p = 0.001). CONCLUSION: Glucose metabolism and myocardial necrosis markers were the best predictors of hyperglycemia in patients with acute myocardial infarction.


Assuntos
Diabetes Mellitus/diagnóstico , Hiperglicemia/diagnóstico , Infarto do Miocárdio/sangue , Troponina/sangue , Biomarcadores/sangue , Coagulação Sanguínea/fisiologia , Creatina Quinase Forma MB/sangue , Diabetes Mellitus/sangue , Métodos Epidemiológicos , Feminino , Hemoglobina A Glicada/análise , Humanos , Hiperglicemia/sangue , Inflamação/sangue , Insulina/sangue , Lipoproteínas/sangue , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/patologia , Necrose , Estresse Fisiológico/fisiologia
17.
Braz J Infect Dis ; 12(3): 226-33, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18833408

RESUMO

This study verified the correlation between the serum levels of TNF alpha and different clinical forms of tuberculosis. We described a group of 24 patients presenting several clinical forms of tuberculosis and a control group of 13 healthy individuals. The levels of TNF alpha were measured by bioassay method. The levels of TNF-alpha had significant differences between the tuberculosis and control groups. The patients with abnormal chest X-Ray findings had higher TNF alpha levels (15328.48 +/- 4602.19 pg/mL) when compared to patients with normal X-Rays (3353.18 +/- 1495.29 pg/mL) (p<0.05). Patients that lost weight had higher TNF alpha levels (15468.54 +/- 4580.54 pg/mL) than those that didn't loose weight (2904.98 +/- 1367.89) (p<0.05). The levels of TNF alpha were higher in patients with a positive PPD skin test than in those with a negative PPD test (p<0.05). There was a positive correlation between patients' clinical severity and the serum levels of TNF alpha. In patients with successive measurements of TNF alpha, we observed that there was a drop in cytokine levels, and also a clinical improvement concomitantly. We concluded that there was a correlation between serum TNF alpha levels and chest X-Ray alterations, loss of weight, positive PPD skin test and clinical severity in patients with tuberculosis. There was evidence of a worse clinical outcome in patients with tuberculosis that presented higher TNF alpha serum levels.


Assuntos
Índice de Gravidade de Doença , Tuberculose/sangue , Fator de Necrose Tumoral alfa/sangue , Adulto , Idoso , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
18.
Mundo saúde (Impr.) ; 32(3): 339-346, jul.-set. 2008. mapas, tab, graf, ilus
Artigo em Português | LILACS | ID: lil-505699

RESUMO

A Bromeliaceae Tillandsia stricta é uma epífita vascular caracterizada como espécie atmosférica, devido à sua capacidade de absorver os nutrientes que necessita diretamente do ar, pelas folhas. Essa bromélia encontra-se distribuída em abundância ao longo de alguns forófitos encontrados no Parque Estadual da Ilha Anchieta em Ubatuba (SP) sendo rara em outros. Neste trabalho procurou-se determinar a existência de possíveis diferenças quanto à temperatura e umidade relativa do ar em três locais (Praia do Presídio, Trilha do Saco Grande e Praia das Palmas), onde essa espécie apresenta distribuição irregular. Além disso, avaliou-se o estado trófico, através da análise de macro e micronutrientes presentes nas folhas. Foram encontradas diferenças significativas de umidade relativa do ar que é maior na Praia do Presídio e Saco Grande e menor na Praia das Palmas. Quanto aos nutrientes, na Praia do Presídio, T. stricta apresentou maiores concentrações de ferro quando comparadas aos outros dois locais. As diferenças nesses fatores abióticos podem explicar a maior concentração de indivíduos de T. stricta existente na Praia do Presídio.


Bromeliaceae Tillandsia stricta is a vascular epiphyte characterized as an atmospheric species due to its capacity of absorbing the nutrients it needs directly from the air through its leaves. This bromeliad is distributed in abundance along some phorophytes found in the State Park of Anchieta Island in Ubatuba (SP), being rare in others. In this work we tried to establish the existence of possible differences regarding temperature and relative humidity of air in three places (Praia do Presídio, Trilha do Saco Grande e Praia das Palmas), where this species presents irregular distribution. Besides, the trophic state was evaluated through the analysis of macro and micronutrients present in the leaves. We found significant differences of relative humidity of air that are greater in Praia do Presídio and Saco Grande and lesser in Praia das Palmas. As for the nutrients, in Praia do Presídio T. stricta presented higher concentrations of iron when compared to the other two places. The differences in these abiotic factors may explain the highest concentration of T. stricta individuals in Praia do Presídio.


La Bromeliaceae Tillandsia stricta es un epifito vascular caracterizado como una especie atmosférica debido a su capacidad de absorber los nutrientes que necesita directamente del aire de promedio sus hojas. Esta bromelia se distribuí en abundancia a lo largo de algúnos forofitos encontrados en el Parque Estatal de Isla Anchieta en Ubatuba (SP), siendo rara en otros. Con este trabajo, tratamos de establecer laexistencia de diferencias posibles en cuanto a la temperaturas y la humedad relativa del aire en tres sitios (Praia del Presídio, Trilha do Saco Grande y Praia das Palmas), donde esta especie presenta distribución irregular. Además, el estado trófico fue evaluado por el análisis de macro y de micronutrientes en las hojas. Encontramos diferencias significativas de humedad relativa del aire que son mayores en Praia del Presídio y Saco Grande y menores en Praia das Palmas. En cuanto a los nutrientes, en Praia del Presídio T. stricta presentó concentraciones más altas de hierro en comparación con los dos otros sitios. Las diferencias en estos factores abióticos pueden explicar la concentración más alta de individuos T. stricta en Praia del Presídio.


Assuntos
Bromeliaceae/crescimento & desenvolvimento , Umidade , Temperatura Ambiente
19.
Braz. j. infect. dis ; 12(3): 226-233, June 2008. graf, tab
Artigo em Inglês | LILACS | ID: lil-493653

RESUMO

This study verified the correlation between the serum levels of TNF alpha and different clinical forms of tuberculosis. We described a group of 24 patients presenting several clinical forms of tuberculosis and a control group of 13 healthy individuals. The levels of TNF alpha were measured by bioassay method. The levels of TNF-alpha had significant differences between the tuberculosis and control groups. The patients with abnormal chest X-Ray findings had higher TNF alpha levels (15328.48 ± 4602.19 pg/mL) when compared to patients with normal X-Rays (3353.18 ± 1495.29 pg/mL) (p<0.05). Patients that lost weight had higher TNF alpha levels (15468.54 ± 4580.54 pg/mL) than those that didn't loose weight (2904.98 ± 1367.89) (p<0.05). The levels of TNF alpha were higher in patients with a positive PPD skin test than in those with a negative PPD test (p<0.05). There was a positive correlation between patients' clinical severity and the serum levels of TNF alpha. In patients with successive measurements of TNF alpha, we observed that there was a drop in cytokine levels, and also a clinical improvement concomitantly. We concluded that there was a correlation between serum TNF alpha levels and chest X-Ray alterations, loss of weight, positive PPD skin test and clinical severity in patients with tuberculosis. There was evidence of a worse clinical outcome in patients with tuberculosis that presented higher TNF alpha serum levels.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Índice de Gravidade de Doença , Tuberculose/sangue , Fator de Necrose Tumoral alfa/sangue , Biomarcadores/sangue , Estudos de Casos e Controles , Adulto Jovem
20.
Mundo saúde (Impr.) ; 30(4): 644-653, out.-dez. 2006. ilus, tab
Artigo em Português | LILACS | ID: lil-456585

RESUMO

Os acidentes ofídicos possuem uma taxa de letalidade mundial de 2,3 no Brasil chega a 6. Nos acidentes crotálicose botrópicos podem ocorrer insuficiência renal aguda (IRA) causada principalmente por necrose tubular aguda (NTA). As princiapiasfrações tóxicas no veneno crotálico é a crotoxina e a fosfolipase A2, no veneno botrópico são as metaloproteinases e a botropsina. Oveneno crotálico pode levar a alterações glomerulares e nos túbulos proximais, entre as principais causas da IRA por NTA consta a arabdomiólise, já o veneno botrópico pode levar a formaçãode trombos, levando o rim a isquemia pela diminuição da perfusão sanguínea.O comprometimento renal por acidentes ofídicos por apresentar comprometimento sistêmico, deixa ainda obscura sobre a patogênesea ação direta do veneno, bem como da terapia com soro antiofídico que da mesma forma ainda não está esclarecido em sua ação emdiminuir uma potencial ação direta do veneno em tecido renal.


Assuntos
Animais Venenosos , Acidentes/estatística & dados numéricos , Imunização , Antígenos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA