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1.
Isr Med Assoc J ; 22(10): 605-611, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33070482

RESUMO

BACKGROUND: There is limited clinical information on coronavirus disease-19 (COVID-19) patients in Israel. OBJECTIVES: To describe the characteristics, outcomes, and potential associations of hospitalized COVID-19 patients in Israel. METHODS: We conducted a single-center, retrospective study of 58 consecutive laboratory-confirmed COVID-19 patients admitted to Laniado Hospital, Israel, between 14 March 2020 and 14 May 2020. Demographic, clinical, and laboratory data on admission were collected and analyzed, and the association to subsequent respiratory failure was assessed. RESULTS: Mean age of patients was 70.7 ± 16.9 years (53% males, 47% females.); 74% had at least one co-morbidity. Most patients were of Jewish Ashkenazi descent. During hospitalization 15 patients (mean age 78.18 ± 10.35 years); 80% male, 73% Sephardi descent developed respiratory failure rates of 60% occurring on average 10.6 days following intubation. Laboratory tests at admission displayed a significant increase in C-reactive protein (CRP) and creatine kinase (CK) and a decrease in absolute lymphocyte count (ALC) in patients who eventually developed respiratory failure (163.97 mg/L, 340.87 IU/L, 0.886 K/µl vs. 50.01 mg/L and 123.56 IU/L, 1.28 K/µl, respectively). Multivariate logistic analysis revealed an integrated parameter of CRP, CK, and ALC highly correlated with respiratory failure. Receiver operating characteristic curve revealed the area under the curve of CRP, CK, and ALC and the integrated parameter to be 0.910, 0.784, and 0.754, respectively. CRP was the strongest predictor to correlate with respiratory failure. CONCLUSIONS: CRP, CK, and ALC levels on admission could possibly be used to detect high-risk patients prone to develop respiratory failure.


Assuntos
Infecções por Coronavirus/epidemiologia , Progressão da Doença , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Insuficiência Respiratória/mortalidade , Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/terapia , Centros Médicos Acadêmicos , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/análise , Estudos de Coortes , Infecções por Coronavirus/prevenção & controle , Creatina Quinase/análise , Testes Diagnósticos de Rotina/métodos , Feminino , Humanos , Israel , Laboratórios Hospitalares/organização & administração , Modelos Logísticos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Avaliação de Resultados em Cuidados de Saúde , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Curva ROC , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/terapia , Estudos Retrospectivos , Taxa de Sobrevida
2.
Rev. int. med. cienc. act. fis. deporte ; 20(79): 381-393, sept. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-197044

RESUMO

El objetivo del presente estudio fue investigar las diferencias en la actividad de la enzima Creatina Quinasa (CK) en pre y post ejercicio anaerobio supramáximo (EASM) en portadores de los genotipos del gen de la alfa-actinina-3 (ACTN3). Se reclutaron 39 hombres sanos físicamente activos (18-35 años) y se sometieron a un EASM de 30 s (Wingate). El gen ACTN3 se determinó a partir del ADN de glóbulos blancos en sangre periférica y se evaluó la actividad de la CK en muestras sanguíneas en condiciones basales, a las 24 y 48 h post EASM. Los portadores del genotipo XX vs RR presentaron 1,4 veces menor actividad de CK en condiciones basales (p < 0,05) y una mayor actividad de CK a las 24 h post ejercicio (p < 0,05). Una serie de EASM fue capaz de causar un incremento significativo de la actividad de CK a las 24 h en los portadores del genotipo XX


The aim of the present study was to investigate the differences in the activity of the enzyme Creatine Kinase (CK) in pre and post anaerobic supramaximal exercise (ASME) on carriers of the genotypes of the alpha-actinin-3 gene (ACTN3). 39 healthy physically active men (18-35 years) were enrolled and underwent an ASME of 30 s (Wingate). The ACTN3 gene was determined from the DNA of white blood cells in peripheral blood and the CK activity was evaluated in blood samples in basal conditions, at 24 and 48 h after of ASME. The carriers of genotype XX vs RR had 1.4 times lower CK activity in basal conditions (p < 0.05) and higher CK activity at 24 h after exercise (p < 0.05). A series of ASME was capable of causing a significant increase in CK activity at 24 h in the XX genotype carriers


Assuntos
Humanos , Masculino , Adolescente , Adulto Jovem , Adulto , Creatina Quinase/sangue , Esforço Físico , Actinina/genética , Anaerobiose/fisiologia , Atividade Motora/fisiologia , Creatina Quinase/análise , Actinina/sangue , Polimorfismo Genético/fisiologia , Estudos Transversais , Inquéritos e Questionários , Ativação Enzimática , Antropometria , Composição Corporal
3.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 46(5): 355-362, jul.-ago. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-197323

RESUMO

La distrofia muscular miotónica tipo 1 (DM1) o enfermedad de Steinert (CIE-9-C: 359.21; CIE-10-ES: G71.11, ORPHA: 273) es una miopatía autosómica dominante de baja prevalencia (<5/10.000) con penetrancia casi completa y daño multiorgánico (neurológico, cardiológico, respiratorio, endocrinológico y digestivo). Es una de las enfermedades humanas con mayor variabilidad clínica. Los síntomas más incapacitantes o molestos para estos enfermos (limitación de la movilidad, cansancio crónico, somnolencia diurna o trastornos digestivos) y sus familias (apatía y falta de iniciativa) no son necesariamente los de peor pronóstico. Las complicaciones respiratorias y los trastornos cardíacos reducen la esperanza de vida de los afectados. No existe tratamiento que modifique su evolución. La función del médico de atención primaria es decisiva en el seguimiento de la DM1, ya sea coordinando a las diferentes especialidades implicadas en el mismo o detectando las complicaciones tratables, en las cuales se centra el presente trabajo


Myotonic dystrophy type 1 (DM1) or Steinert's disease (CIE-9-C: 359.21; CIE-10-ES: G71.11, ORPHA: 273) is a rare autosomal dominant inherited myopathy with almost complete penetrance and multisystemic consequences (neurological, cardiological, respiratory, endocrinological, and gastrointestinal). It is one of the clinical most variable diseases. The most bothersome symptoms for the patients (mobility problems, fatigue, hypersomnia, or gastrointestinal symptoms) and their families (apathy, lack of initiative) are not necessarily the most dangerous. Respiratory problems and cardiac arrhythmias shorten life expectancy. There is no specific treatment. The role of the Primary Care physician is crucial in the follow-up of DM1, either by coordinating the different professionals or detecting treatable complications. This work addresses the latter


Assuntos
Humanos , Distrofia Miotônica/genética , Transtornos de Deglutição/etiologia , Miotonia Congênita/genética , Debilidade Muscular/etiologia , Aberrações Cromossômicas/classificação , Expansão das Repetições de Trinucleotídeos/genética , Creatina Quinase/análise , Equipe de Assistência ao Paciente/organização & administração , Cardiopatias/epidemiologia , Transtornos Respiratórios/epidemiologia , Doenças do Sistema Endócrino/epidemiologia
4.
Res Vet Sci ; 130: 41-47, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32126390

RESUMO

Blood collection at exsanguination is a method of collecting samples at abattoirs which itself has no effect on animal welfare, compared with collection prior to stunning. However, there is the potential for artefact to affect measurements. It was hypothesised that, for most blood analytes measured, the differences between lairage and exsanguination measurements would be minimal, except for creatine kinase, which was expected be higher in exsanguination samples. Fifty-nine male dairy calves approximately 5-10 days old were sampled prior to slaughter, and again during exsanguination after stunning. Each sample was analysed for packed cell volume, serum urea, beta-hydroxybutyrate, gamma-glutamyl transferase, total protein, glucose and creatine kinase concentrations. Exsanguination and lairage blood results were compared using a paired t-test. There were no significant differences between the measurements taken at exsanguination compared with lairage for packed cell volume, urea and beta-hydroxybutyrate. Glucose concentrations were higher in exsanguination samples, and total protein concentrations were lower, but for both of these analytes the differences were clinically small. Gamma-glutamyl transferase activity was lower in exsanguination samples compared with lairage samples. Creatine kinase activity was higher in exsanguination samples. It was concluded that collecting blood at exsanguination is a valid method for collecting samples for measurement of packed cell volume, urea, and beta-hydroxybutyrate in calves. Glucose and total protein can also yield useful measurements in these samples, though care needs to be taken with interpretation given the minor differences between exsanguination and lairage measurements. Exsanguination samples may be unsuitable for creatine kinase and gamma-glutamyl transferase measurement.


Assuntos
Matadouros , Análise Química do Sangue/veterinária , Coleta de Amostras Sanguíneas/veterinária , Creatina Quinase/análise , Animais , Análise Química do Sangue/métodos , Coleta de Amostras Sanguíneas/métodos , Bovinos , Masculino
5.
EuroIntervention ; 15(16): 1444-1450, 2020 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-31829942

RESUMO

AIMS: The optimal cut-off value of isolated cardiac biomarker elevation for defining prognostically important percutaneous coronary intervention (PCI)-related myocardial injury is not known. We performed a meta-analysis to evaluate the dose-response relationship between isolated cardiac biomarker elevations and the risk of all-cause mortality following elective PCI. METHODS AND RESULTS: Twenty-four prospective studies (44,972 patients) were included. Patients with an isolated elevation of cardiac biomarkers had an increased risk of all-cause mortality when compared to those with no elevations (cardiac troponin I: odds ratio [OR] 1.42, 95% confidence interval [CI]: 1.19-1.69; creatine kinase-MB isoenzyme [CK-MB]: OR 1.43, 95% CI: 1.19-1.70). For the dose-response analysis, elevations of cardiac troponin I >3x or CK-MB >1x the 99th percentile upper reference limit (URL) were associated with increased mortality (cardiac troponin I: OR 1.51, 95% CI: 1.05-2.17; CK-MB: OR 1.25, 95% CI: 1.05-1.48). The pooled OR of mortality for each 3xURL increment of cardiac troponin I or CK-MB was 1.33 (95% CI: 1.15-1.53) and 1.38 (95% CI: 1.30-1.47). CONCLUSIONS: We found that a positive dose-response relationship between isolated cardiac troponin I and CK-MB with all-cause mortality and elevated cardiac troponin I >3x or CK-MB >1x the 99th percentile URL was associated with an increased risk of mortality.


Assuntos
Doença da Artéria Coronariana/cirurgia , Creatina Quinase/metabolismo , Intervenção Coronária Percutânea/efeitos adversos , Troponina/metabolismo , Biomarcadores/sangue , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/mortalidade , Creatina Quinase/análise , Creatina Quinase Forma MB , Relação Dose-Resposta a Droga , Humanos , Mortalidade , Miocárdio , Intervenção Coronária Percutânea/mortalidade , Estudos Prospectivos , Troponina/análise
6.
J Sports Sci ; 38(11-12): 1423-1431, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31456474

RESUMO

The current study compared cold-water immersion (CWI) and active recovery (AR) to static stretching (SS) on muscle recovery post-competitive soccer matches in elite youth players (n = 15). In a controlled crossover design, participants played a total of nine competitive soccer games, comprising three 80 minute games for each intervention (SS, CWI and AR). Muscle oedema, creatine kinase (CK), countermovement jump performance (CMJA) and perceived muscle soreness (PMS) were assessed pre-, immediately post-, and 48 hours post-match and compared across time-intervals and between interventions. Following SS, all markers of muscle damage remained significantly elevated (P < 0.05) compared to baseline at 48 hours post-match. Following AR and CWI, CMJA returned to baseline at 48 hours post-match, whilst CK returned to baseline following CWI at 48 hours post-match only. Analysis between recovery interventions revealed a significant improvement in PMS (P < 0.05) at 48 hours post-match when comparing AR and CWI to SS, with no significant differences between AR and CWI observed (P > 0.05). Analysis of %change for CK and CMJA revealed significant improvements for AR and CWI compared to SS. The present study indicated both AR and CWI are beneficial recovery interventions for elite young soccer players following competitive soccer matches, of which were superior to SS.


Assuntos
Temperatura Baixa , Comportamento Competitivo/fisiologia , Hidroterapia/métodos , Imersão , Fadiga Muscular/fisiologia , Exercícios de Alongamento Muscular/métodos , Mialgia/prevenção & controle , Futebol/fisiologia , Adolescente , Creatina Quinase/análise , Estudos Cross-Over , Edema/prevenção & controle , Humanos , Músculo Esquelético/enzimologia , Músculo Esquelético/lesões , Água
7.
J Emerg Med ; 57(6): e181-e183, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31767218

RESUMO

BACKGROUND: Haff disease is a rare syndrome of rhabdomyolysis thought to be caused by a heat-stable toxin associated with the consumption of seafood from fresh or brackish water. CASE REPORT: We present the case of a patient with Haff disease who presented to the emergency department with nausea/vomiting, diarrhea, and myalgias after a seafood buffet. Initially, he was treated with i.v. fluids and antiemetics for presumed gastroenteritis, but his symptoms did not improve. He was found to have elevated aspartate aminotransferase and alanine aminotransferase, normal point-of-care ultrasound, urinalysis with large blood and no red blood cells, and an elevated creatine phosphokinase (CPK). He was admitted to the hospital to receive ongoing fluid resuscitation for rhabdomyolysis presumed to be from fish. Liver enzymes and CPK downtrended, and patient was discharged on hospital day 3. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Undiagnosed Haff disease has important clinical implications, including multi-organ failure and death. Always maintain a high level of suspicion for Haff disease in patients with symptoms suggestive of gastroenteritis, but complicated by minor liver function test elevations and dipstick positivity for heme, without significant numbers of red blood cells per high-power field, in the setting of recent seafood ingestion.


Assuntos
Enzimas/análise , Fígado/enzimologia , Rabdomiólise/sangue , Adulto , Alanina Transaminase/análise , Alanina Transaminase/sangue , Aspartato Aminotransferases/análise , Aspartato Aminotransferases/sangue , Creatina Quinase/análise , Creatina Quinase/sangue , Diarreia/etiologia , Serviço Hospitalar de Emergência/organização & administração , Enzimas/sangue , Humanos , Fígado/fisiopatologia , Masculino , Rabdomiólise/complicações , Rabdomiólise/fisiopatologia , Águas Salinas/efeitos adversos , Alimentos Marinhos/efeitos adversos , Vômito/etiologia
9.
Arch Argent Pediatr ; 117(5): e493-e496, 2019 10 01.
Artigo em Espanhol | MEDLINE | ID: mdl-31560498

RESUMO

Acute viral myositis is a complication after a viral infection mainly caused by Influenza A and B viruses. It is characterized as a transitory, sudden, self-limiting and benign inflammatory process. It usually affects preschool and school children presenting bilateral pain and sensitivity in the muscle groups of the lower limbs without alteration in the neurological examination. It can affect the gait or standing. The main complication is rhabdomyolysis, which is why clinical followup and values of creatine phosphokinase must be done. We present the case of a school-age child diagnosed with acute viral myositis. Because it is not a frequent entity and its incidence in Latin America is unknown, we consider important to report the case and review the topic, as its clinical course is benign, easily treated, and its knowledge can avoid unnecessary studies and hospitalizations.


Assuntos
Creatina Quinase/análise , Influenza Humana/complicações , Miosite/etiologia , Doença Aguda , Criança , Humanos , Masculino , Miosite/diagnóstico , Miosite/virologia , Rabdomiólise/etiologia , Rabdomiólise/prevenção & controle
10.
Klin Lab Diagn ; 64(7): 405-408, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31408591

RESUMO

The purpose of the investigation was to study the efficiency of measuring markers of oxidative stress and muscle damage in the oral fluid in highly skilled sportsmen under physical exercise for the assessment of their functional state. 70 highly qualified athletes at the age of 16-20 years specializing in the cyclic kinds of sports (track and field, swimming) took part in the investigation. Sportsmen performed the control test which consisted of the series of 3×100 m distances by a flat race with an active 45 s rest between them for the track and field athletes, and 4×50 m by the main swimming style with an active rest between the distances also for 45 s for the swimmers. Activity of creatine kinase, content of lipid peroxidation products in the blood and oral fluid were measured standard biochemical methods. The performance of the functional tests induces the excessive accumulation of toxic products of lipoperoxidation and increases activity of creatine kinase in the oral fluid of highly qualified athletes. Correlation analysis shows, that the intensity of free radical and peroxide processes in athletes can be evaluated by means of the method of measuring the content of lipid peroxidation products in the oral fluid.


Assuntos
Atletas , Exercício Físico/fisiologia , Peroxidação de Lipídeos , Saliva/química , Creatina Quinase/análise , Humanos , Peróxidos Lipídicos/análise
11.
J Med Case Rep ; 13(1): 270, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31455390

RESUMO

BACKGROUND: Hypothyroidism is a common medical disorder which results in many metabolic effects, such as dyslipidemia, hypertension, accelerated atherosclerosis, and coronary artery disease. Hypothyroidism affects the renal physiology by affecting the renal blood flow, vascular resistance, and sodium handling. Recent studies have shown hypothyroidism is associated with decreased estimated renal function and proteinuria. Rhabdomyolysis and acute renal insufficiency have also been described in association with hypothyroidism. The severity of the proteinuria was directly proportional to thyroid-stimulating hormone levels. Currently, there is a lack of evidence on the reversibility of proteinuria in hypothyroidism. This is the first report in the literature, to the best of our knowledge, demonstrating the reversibility of proteinuria associated with hypothyroidism, with treatment. CASE PRESENTATION: Here we describe two cases, a 72-year-old Sinhalese man and a 47-year-old Tamil woman, from Sri Lanka, presenting with overt hypothyroidism; they were found to have elevated creatinine, proteinuria, and elevated creatinine kinase levels. Due to lack of active sediment in urine analysis, these patients were observed after the initiation of thyroxine therapy. They were investigated in the adult-onset proteinuria pathway, excluding common reasons for proteinuria. Both patients responded to treatment: their serum creatinine, creatinine kinase, and urine protein levels reverted to physiological levels within 6 months of treatment with thyroxine, and with normalization of thyroid-stimulating hormone. CONCLUSION: Hypothyroidism can present as renal insufficiency, proteinuria, and can mimic rhabdomyolysis. Prompt initiation of thyroxine treatment and control of thyroid-stimulating hormone levels could reverse these changes.


Assuntos
Hipotireoidismo/diagnóstico , Proteinúria/etiologia , Idoso , Creatina Quinase/análise , Creatinina/análise , Feminino , Terapia de Reposição Hormonal , Humanos , Hipotireoidismo/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Proteinúria/tratamento farmacológico , Tiroxina/uso terapêutico
12.
Respir Care ; 64(7): 835-843, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31138728

RESUMO

BACKGROUND: Among the types of physical exercise, resistance exercises have been gaining significant attention in the COPD population. The aim of this study was to compare effects of conventional resistance training and of training by using elastic tubes on muscle strength, exercise capacity, and creatine kinase clearance in subjects with COPD. METHODS: Twenty-eight subjects with COPD were randomized into the following: resistance training with the elastic tubing group and resistance training with the weight-machine training group (conventional resistance group), performed 3 times a week for 12 weeks. The subjects were submitted to spirometry, functional exercise capacity (the 6-min walk test), muscle strength (dynamometry), and the repetition maximum test. Differences between the initial and final evaluations (Δ) and the (final - initial evaluations)/initial evaluations ×100 (Δ%) of each group were expressed as mean [95% CI]. RESULTS: Nineteen subjects (FEV1 % predicted, 52 ± 18; years, 65 ± 8) completed the training program. Similar improvements were observed in both modalities on muscle strength (knee extension, Δ%18 [6 to 29]; knee flexion, Δ%35 [17 to 54]; elbow flexion, Δ%28 [9 to 48]; shoulder abduction, Δ%41 [25 to 58] and shoulder flexion, Δ%31 [11 to 51] in the weight-machine training group (conventional resistance group); knee extension, Δ%15 [8 to 21]; knee flexion, Δ%28 [15 to 41]; elbow flexion, Δ%36 [22 to 51]; and shoulder abduction, Δ%43 [32 to 55] and shoulder flexion, Δ%43 [25 to 61] in the elastic tubing group, P < .05 for intra-group analysis and P > .05 for between groups analysis), 6-min walk test (baseline 493 ± 67m vs 12 weeks 526 ± 78 in the weight-machine training group (P = .10); baseline 493 ± 71 vs 12 weeks 524 ± 68 in the elastic tubing group (P < .01), P = .88 between groups). The elastic tubing group had lower accumulated creatine kinase levels between 24 and 72 h ((Δ%-24 [-31 to 16] than subjects in the weight-machine training group Δ%3 [-21 to 28], P = .042 between the groups. CONCLUSIONS: Training with elastic resistance provided similar changes in muscle strength and exercise capacity to conventional resistance group in the subjects with COPD. The elastic tubing group had faster creatine kinase clearance after a training session than the weight-machine training group (conventional resistance group). The ease of its application associated with similar training benefits to conventional training supported its application in clinical routine.


Assuntos
Terapia por Exercício/métodos , Tolerância ao Exercício , Força Muscular , Doença Pulmonar Obstrutiva Crônica , Treinamento de Resistência/métodos , Creatina Quinase/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/metabolismo , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/terapia , Testes de Função Respiratória , Resultado do Tratamento
13.
Mil Med ; 184(11-12): 820-825, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31090905

RESUMO

INTRODUCTION: Rhabdomyolysis is often encountered in austere environments where the diagnosis can be challenging due to the expense or unavailability of creatine phosphokinase (CPK) testing. CPK concentration ≥5,000 U/L has previously been found to be a sensitive marker for progression to renal failure. This study sought to propose a model utilizing an alternate biomarker to allow for the diagnosis and monitoring of clinically significant rhabdomyolysis in the absence of CPK. MATERIALS AND METHODS: We performed a retrospective chart review of 77 patients admitted to a tertiary medical center with a primary diagnosis of rhabdomyolysis. A linear regression model with aspartate aminotransferase (AST) as the independent variable was developed and used to predict CPK ≥5,000 U/L on admission and CPK values on subsequent hospital days. The study was approved and monitored by the Institutional Review Board at Walter Reed National Military Medical Center. RESULTS: Ln(AST) explained over 80% of the variance in ln(CPK) (adjusted R2 = 0.802). The diagnostic accuracy to predict CPK ≥5,000 U/L was high (AUC 0.959; 95% CI: 0.921-0.997, P < 0.001). A cut point of AST ≥110 U/L in our study population had a 97.1% sensitivity and an 85.7% specificity for the detection of a CPK value ≥5,000 U/L. The agreement between actual CPK and predicted CPK for subsequent days of hospitalization was fair with an intraclass correlation coefficient of 0.52 (95% CI: 0.38-0.63). The developed model based on day 1 data tended to overpredict CPK values on subsequent hospital days. CONCLUSIONS: We propose a threshold concentration of AST that has an excellent sensitivity for detecting CPK concentration ≥5,000 U/L on day of admission in a patient population with a diagnosis of rhabdomyolysis. A formula with a fair ability to predict CPK levels based on AST concentrations on subsequent hospital days was also developed.


Assuntos
Creatina Quinase/análise , Rabdomiólise/diagnóstico , Rabdomiólise/terapia , Adulto , Aspartato Aminotransferases/análise , Aspartato Aminotransferases/sangue , Biomarcadores/análise , Biomarcadores/sangue , Creatina Quinase/sangue , Creatina Quinase Forma MB/análise , Creatina Quinase Forma MB/sangue , Feminino , Humanos , Modelos Lineares , Masculino , Registros Médicos/estatística & dados numéricos , Pessoa de Meia-Idade , Estudos Retrospectivos , Rabdomiólise/sangue , Estados Unidos
15.
Cryobiology ; 88: 29-37, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30981678

RESUMO

Oxidative stress is involved in the pathogenesis of ischemia-reperfusion during myocardial transplantation. Therefore, graft preservation solutions may be improved by supplementation with antioxidants to minimize graft dysfunction caused by cold ischemic injury. Propolis is a polyphenol-rich substance which has an important antioxidant activity. The protective effect of propolis against oxidative stress induced by prolonged cold preservation of heart was investigated. Mice were subjected to a hypothermic model of ischemia in which hearts were preserved for 24 h at 4 °C in Krebs-Hensleit (KH) solution in the absence or presence of propolis concentrations (50, 150 and 250 µg/ml). Levels of released Lactate dehydrogenase (LDH), Creatine phosphokinase (CPK) and Troponine-I (Trop I) were assessed in the preservation solution and histological assessement of heart ischemia injuries was performed. Oxidative stress biomarkers malondialdehyde (MDA) and advanced oxidation protein products (AOPP) and antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) were assessed in cardiac tissue. Mitochondria were isolated from stored hearts and production of reactive oxygen species (ROS) was tested. Propolis supplementation protected efficiently hearts during preservation by reducing significantly levels of lipids and proteins oxidation and restoring activities of antioxidant enzymes. Also, propolis preserved tissue integrity altered by hypothermic ischemia in a concentration-dependent manner. Propolis reduced significantly the rate of H2O2 produced by mitochondrial respiration, the best antioxidant effect being obtained at the highest propolis concentration (250 µg/ml). Algerian propolis is a non-temperature sensitive scavenger that protects heart from oxidative damage induced by prolonged hypothermic ischemia.


Assuntos
Antioxidantes/farmacologia , Criopreservação/métodos , Crioprotetores/farmacologia , Preservação de Órgãos/métodos , Estresse Oxidativo/efeitos dos fármacos , Própole/farmacologia , Animais , Creatina Quinase/análise , Sobrevivência de Enxerto/efeitos dos fármacos , Coração/efeitos dos fármacos , Transplante de Coração/métodos , Peróxido de Hidrogênio/metabolismo , L-Lactato Desidrogenase/análise , Masculino , Malondialdeído/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Mitocôndrias/metabolismo , Miocárdio/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Superóxido Dismutase/metabolismo , Troponina I/análise
17.
Genet Test Mol Biomarkers ; 23(4): 255-263, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30986096

RESUMO

AIMS: Periodontitis results from the presence of periodontopathogenic bacterial activity in the region of the gingival sulcus promoting tissue degradation and alveolar bone resorption. Biochemical analysis of the saliva can be used as a less invasive method for disease prognosis. This study aimed to evaluate the relationship between biochemical protein levels in the saliva sample of patients with chronic periodontitis and healthy patients. MATERIALS AND METHODS: A literature review was performed using electronic databases (Cochrane Library, Google Scholar, MEDLINE, PubMed, and Web of Science) for studies published before July 2, 2016. The abstracts were evaluated, and the data extraction was performed by two calibrated examiners. The mean difference, and heterogeneity were calculated, and funnel plots were produced. RESULTS: Twenty case-control studies were selected with 2436 patients with chronic periodontitis and 1787 controls. The meta-analysis showed that increased levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CK), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), and acid phosphatase (ACP) were all associated with periodontitis (p < 0.05), while blood urea nitrogen (BUN) and osteoprotegerin (OPG) levels did not show statistical differences between cases and controls (p > 0.05). CONCLUSIONS: This meta-analysis evidenced that increased levels of AST, ALT, CK, gama glutamil transferase (GGT), LDH, ALP, and ACP are associated in patients with chronic periodontitis, while BUN and OPG level in saliva did not present differences between groups.


Assuntos
Periodontite Crônica/metabolismo , Periodontite Crônica/fisiopatologia , Fosfatase Ácida/análise , Fosfatase Ácida/sangue , Adulto , Alanina Transaminase/análise , Alanina Transaminase/sangue , Fosfatase Alcalina/análise , Fosfatase Alcalina/sangue , Aspartato Aminotransferases/análise , Aspartato Aminotransferases/sangue , Estudos de Casos e Controles , Creatina Quinase/análise , Creatina Quinase/sangue , Feminino , Humanos , L-Lactato Desidrogenase/análise , L-Lactato Desidrogenase/sangue , Masculino , Saliva/química
19.
J Emerg Med ; 56(5): 551-553, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30898458

RESUMO

BACKGROUND: Exertional rhabdomyolysis is a common condition with potentially life-threatening consequences; early recognition can prevent severe downstream complications. Some migrants and undocumented immigrants who have travelled to the United States have encountered extreme heat or other austere conditions during their journey, many of which have involved long stretches of travel on foot. These factors can combine to put these migrants at risk for rhabdomyolysis. Hospitals near the border of Mexico and the United States commonly encounter patients with adverse medical complications related to the process of border crossing. CASE REPORT: We report a patient with exertional rhabdomyolysis complicated by acute kidney injury who presented to a hospital located thousands of miles from the United States-Mexico border. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Undocumented immigrants frequently disperse to disparate metropolitan areas after crossing the border, and therefore medical providers should remain vigilant for the medical complications of this dangerous journey.


Assuntos
Esforço Físico , Rabdomiólise/complicações , Rabdomiólise/diagnóstico , Lesão Renal Aguda/etiologia , Antibacterianos/uso terapêutico , Clindamicina/uso terapêutico , Creatina Quinase/análise , Creatina Quinase/sangue , Feminino , Fluconazol/uso terapêutico , Humanos , New York , Imigrantes Indocumentados , Adulto Jovem
20.
Clin Chem Lab Med ; 57(9): 1388-1396, 2019 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-30860975

RESUMO

Background Many reports address the stability of biochemical analytes in serum. However, studies covering a wide range of storage temperatures are unavailable. Using equipment enabling precise temperature control, we investigated the effect of six different storage temperatures on serum analytes. Methods Serum specimens from seven healthy volunteers were obtained and divided into multiple aliquots for storage at -30, -20, -10, 0, 4, and 25 °C. On days 1, 3, 7, 14, 28 and 56, the aliquots stored at each temperature were relocated to a deep freezer maintained at -80 °C. On day 60, all aliquots were measured collectively for 13 major chemistry analytes. Results (1) At 25 °C, alanine aminotransferase (ALT), creatine kinase (CK), aspartate aminotransferase (AST) and total bilirubin (TBil) were very unstable especially on day 7 and later. (2) At ≤4 °C, alkaline phosphatase (ALP), γ-glutamyltransferase (GGT), amylase (AMY), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG), TBil and complement component-4 (C4) were generally stable and were very stable at 25 °C until day 14. (3) Between -20 and 4 °C, especially at -10 °C, test results of ALT, AST and lactate dehydrogenase (LDH) showed prominent decreases, but their stability was greatly improved at -30 °C. (4) In contrast, the value of complement component-3 (C3) increased at ≥- 20 °C. (5) At -30 °C, test results of all analytes were generally very stable except for ALT and CK, which showed noticeable reductions in activity after 14 days. Conclusions This is the first study to assess the stability of serum analytes at six graded temperatures simultaneously. Each analyte has a unique stability pattern for a range of temperatures.


Assuntos
Coleta de Amostras Sanguíneas/métodos , Técnicas de Química Analítica/métodos , Temperatura , Alanina Transaminase/análise , Alanina Transaminase/sangue , Fosfatase Alcalina/análise , Fosfatase Alcalina/sangue , Aspartato Aminotransferases/análise , Aspartato Aminotransferases/sangue , Bilirrubina/análise , Bilirrubina/sangue , Preservação de Sangue/métodos , Técnicas de Química Analítica/normas , Colesterol/análise , Colesterol/sangue , Creatina Quinase/análise , Creatina Quinase/sangue , L-Lactato Desidrogenase/análise , L-Lactato Desidrogenase/sangue , Valores de Referência , Soro/química , Fatores de Tempo , Triglicerídeos/análise , Triglicerídeos/sangue , gama-Glutamiltransferase/análise , gama-Glutamiltransferase/sangue
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