Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 18.231
Filtrar
1.
Acta Vet Scand ; 66(1): 24, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38822358

RESUMO

BACKGROUND: A syndrome of acute non-cardiogenic pulmonary edema associated with hunting is prevalent in the drever breed, but etiology of this syndrome is currently unknown. Alveolar surfactant has a critical role in preventing alveolar collapse and edema formation. The aim of this study was to investigate, whether the predisposition to hunting associated pulmonary edema in drever dogs is associated with impaired biophysical properties of alveolar surfactant. Seven privately owned drever dogs with recurrent hunting associated pulmonary edema and seven healthy control dogs of other breeds were included in the study. All affected dogs underwent thorough clinical examinations including echocardiography, laryngeal evaluation, bronchoscopy, and bronchoalveolar lavage (BAL) as well as head, neck and thoracic computed tomography imaging to rule out other cardiorespiratory diseases potentially causing the clinical signs. Alveolar surfactant was isolated from frozen, cell-free supernatants of BAL fluid and biophysical analysis of the samples was completed using a constrained sessile drop surfactometer. Statistical comparisons over consecutive compression expansion cycles were performed using repeated measures ANOVA and comparisons of single values between groups were analyzed using T-test. RESULTS: There were no significant differences between groups in any of the biophysical outcomes of surfactant analysis. The critical function of surfactant, reducing the surface tension to low values upon compression, was similar between healthy dogs and affected drevers. CONCLUSIONS: The etiology of hunting associated pulmonary edema in drever dogs is not due to an underlying surfactant dysfunction.


Assuntos
Doenças do Cão , Edema Pulmonar , Surfactantes Pulmonares , Animais , Cães , Edema Pulmonar/veterinária , Edema Pulmonar/etiologia , Masculino , Feminino , Líquido da Lavagem Broncoalveolar/química , Estudos de Casos e Controles
2.
Europace ; 26(6)2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38864730

RESUMO

AIMS: Patients with structural heart disease (SHD) undergoing catheter ablation (CA) for ventricular tachycardia (VT) are at considerable risk of periprocedural complications, including acute haemodynamic decompensation (AHD). The PAINESD score was proposed to predict the risk of AHD. The goal of this study was to validate the PAINESD score using the retrospective analysis of data from a large-volume heart centre. METHODS AND RESULTS: Patients who had their first radiofrequency CA for SHD-related VT between August 2006 and December 2020 were included in the study. Procedures were mainly performed under conscious sedation. Substrate mapping/ablation was performed primarily during spontaneous rhythm or right ventricular pacing. A purposely established institutional registry for complications of invasive procedures was used to collect all periprocedural complications that were subsequently adjudicated using the source medical records. Acute haemodynamic decompensation triggered by CA procedure was defined as intraprocedural or early post-procedural (<12 h) development of acute pulmonary oedema or refractory hypotension requiring urgent intervention. The study cohort consisted of 1124 patients (age, 63 ± 13 years; males, 87%; ischaemic cardiomyopathy, 67%; electrical storm, 25%; New York Heart Association Class, 2.0 ± 1.0; left ventricular ejection fraction, 34 ± 12%; diabetes mellitus, 31%; chronic obstructive pulmonary disease, 12%). Their PAINESD score was 11.4 ± 6.6 (median, 12; interquartile range, 6-17). Acute haemodynamic decompensation complicated the CA procedure in 13/1124 = 1.2% patients and was not predicted by PAINESD score with AHD rates of 0.3, 1.8, and 1.1% in subgroups by previously published PAINESD terciles (<9, 9-14, and >14). However, the PAINESD score strongly predicted mortality during the follow-up. CONCLUSION: Primarily substrate-based CA of SHD-related VT performed under conscious sedation is associated with a substantially lower rate of AHD than previously reported. The PAINESD score did not predict these events. The application of the PAINESD score to the selection of patients for pre-emptive mechanical circulatory support should be reconsidered.


Assuntos
Ablação por Cateter , Hemodinâmica , Taquicardia Ventricular , Humanos , Taquicardia Ventricular/cirurgia , Taquicardia Ventricular/fisiopatologia , Taquicardia Ventricular/etiologia , Taquicardia Ventricular/diagnóstico , Masculino , Feminino , Pessoa de Meia-Idade , Ablação por Cateter/efeitos adversos , Estudos Retrospectivos , Cicatriz/fisiopatologia , Idoso , Hipotensão/etiologia , Hipotensão/fisiopatologia , Hipotensão/diagnóstico , Edema Pulmonar/etiologia , Edema Pulmonar/diagnóstico , Edema Pulmonar/fisiopatologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/diagnóstico , Fatores de Risco
4.
Narra J ; 4(1): e691, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38798849

RESUMO

Radiological examinations such as chest X-rays (CXR) play a crucial role in the early diagnosis and determining disease severity in coronavirus disease 2019 (COVID-19). Various CXR scoring systems have been developed to quantitively assess lung abnormalities in COVID-19 patients, including CXR modified radiographic assessment of lung edema (mRALE). The aim of this study was to determine the relationship between mRALE scores and clinical outcome (mortality), as well as to identify the correlation between mRALE score and the severity of hypoxia (PaO2/FiO2 ratio). A retrospective cohort study was conducted among hospitalized COVID-19 patients at Dr. Soetomo General Academic Hospital Surabaya, Indonesia, from February to April 2022. All CXR data at initial admission were scored using the mRALE scoring system, and the clinical outcomes at the end of hospitalization were recorded. Of the total 178 COVID-19 patients, 62.9% survived after completing the treatment. Patients within non-survived had significantly higher quick sequential organ failure assessment (qSOFA) score (p<0.001), lower PaO2/FiO2 ratio (p=0.004), and higher blood urea nitrogen (p<0.001), serum creatinine (p<0.008) and serum glutamic oxaloacetic transaminase (p=0.001) levels. There was a significant relationship between mRALE score and clinical outcome (survived vs deceased) (p=0.024; contingency coefficient of 0.184); and mRALE score of ≥2.5 served as a risk factor for mortality among COVID-19 patients (relative risk of 1.624). There was a significant negative correlation between the mRALE score and PaO2/FiO2 ratio based on the Spearman correlation test (r=-0.346; p<0.001). The findings highlight that the initial mRALE score may serve as an independent predictor of mortality among hospitalized COVID-19 patients as well as proves its potential prognostic role in the management of COVID-19.


Assuntos
COVID-19 , Radiografia Torácica , Índice de Gravidade de Doença , Humanos , COVID-19/diagnóstico por imagem , COVID-19/mortalidade , Indonésia , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Radiografia Torácica/métodos , Adulto , Edema Pulmonar/diagnóstico por imagem , Edema Pulmonar/mortalidade , SARS-CoV-2 , Idoso , Prognóstico
5.
Med. intensiva (Madr., Ed. impr.) ; 48(5): 272-281, mayo.-2024. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-ADZ-391

RESUMO

El síndrome de dificultad respiratoria aguda (SDRA), inicialmente descrito en 1967, se caracteriza por insuficiencia respiratoria aguda con hipoxemia profunda, disminución de la distensibilidad pulmonar e infiltrados bilaterales en la Rx de tórax. En 2012 la definición de Berlín estableció tres categorías con base en la hipoxemia (SDRA leve, moderado y grave), precisando aspectos temporales y permitiendo el diagnóstico con ventilación no invasiva. La pandemia de COVID-19 llevó a reconsiderar la definición, enfocándose en el monitoreo continuo de la oxigenación y la oxigenoterapia de alto flujo. En 2021 se propuso una nueva definición global de SDRA, basada en la definición de Berlín, pero incluyendo una categoría para pacientes no intubados, permitiendo el uso de saturación periférica de oxígeno medida con oximetría de pulso/fracción inspirada de oxígeno (SpO2/FiO2) y la ecografía pulmonar para el diagnóstico, y sin ningún requerimiento de soporte especial de la oxigenación en regiones con recursos limitados. Aunque persisten debates, la evolución continua busca adaptarse a las necesidades clínicas y epidemiológicas, y personalizar tratamientos. (AU)


Acute respiratory distress syndrome (ARDS), first described in 1967, is characterized by acute respiratory failure causing profound hypoxemia, decreased pulmonary compliance, and bilateral CXR infiltrates. After several descriptions, the Berlin definition was adopted in 2012, which established three categories of severity according to hypoxemia (mild, moderate and severe), specified temporal aspects for diagnosis, and incorporated the use of non-invasive ventilation. The COVID-19 pandemic led to changes in ARDS management, focusing on continuous monitoring of oxygenation and on utilization of high-flow oxygen therapy and lung ultrasound. In 2021, a New Global Definition based on the Berlin definition of ARDS was proposed, which included a category for non-intubated patients, considered the use of SpO2, and established no particular requirement for oxygenation support in regions with limited resources. Although debates persist, the continuous evolution seeks to adapt to clinical and epidemiological needs, and to the search of personalized treatments. (AU)


Assuntos
Humanos , Síndrome do Desconforto Respiratório do Recém-Nascido , Edema Pulmonar , Respiração Artificial , Hipóxia
6.
Mol Med ; 30(1): 68, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38778274

RESUMO

BACKGROUND: Acute respiratory distress syndrome (ARDS) is characterized by alveolar edema that can progress to septal fibrosis. Mechanical ventilation can augment lung injury, termed ventilator-induced lung injury (VILI). Connective tissue growth factor (CTGF), a mediator of fibrosis, is increased in ARDS patients. Blocking CTGF inhibits fibrosis and possibly vascular leakage. This study investigated whether neutralizing CTGF reduces pulmonary edema in VILI. METHODS: Following LPS administration, rats were mechanically ventilated for 6 h with low (6 mL/kg; low VT) or moderate (10 mL/kg; mod VT) tidal volume and treated with a neutralizing CTGF antibody (FG-3154) or placebo lgG (vehicle). Control rats without LPS were ventilated for 6 h with low VT. Lung wet-to-dry weight ratio, FITC-labeled dextran permeability, histopathology, and soluble RAGE were determined. RESULTS: VILI was characterized by reduced PaO2/FiO2 ratio (low VT: 540 [381-661] vs. control: 693 [620-754], p < 0.05), increased wet-to-dry weight ratio (low VT: 4.8 [4.6-4.9] vs. control: 4.5 [4.4-4.6], p < 0.05), pneumonia (low VT: 30 [0-58] vs. control: 0 [0-0]%, p < 0.05) and interstitial inflammation (low VT: 2 [1-3] vs. control: 1 [0-1], p < 0.05). FG-3154 did not affect wet-to-dry weight ratio (mod VT + FG-3154: 4.8 [4.7-5.0] vs. mod VT + vehicle: 4.8 [4.8-5.0], p > 0.99), extravasated dextrans (mod VT + FG-3154: 0.06 [0.04-0.09] vs. mod VT + vehicle: 0.04 [0.03-0.09] µg/mg tissue, p > 0.99), sRAGE (mod VT + FG-3154: 1865 [1628-2252] vs. mod VT + vehicle: 1885 [1695-2159] pg/mL, p > 0.99) or histopathology. CONCLUSIONS: 'Double hit' VILI was characterized by inflammation, impaired oxygenation, pulmonary edema and histopathological lung injury. Blocking CTGF does not improve oxygenation nor reduce pulmonary edema in rats with VILI.


Assuntos
Fator de Crescimento do Tecido Conjuntivo , Edema Pulmonar , Lesão Pulmonar Induzida por Ventilação Mecânica , Animais , Lesão Pulmonar Induzida por Ventilação Mecânica/tratamento farmacológico , Lesão Pulmonar Induzida por Ventilação Mecânica/metabolismo , Lesão Pulmonar Induzida por Ventilação Mecânica/patologia , Fator de Crescimento do Tecido Conjuntivo/metabolismo , Fator de Crescimento do Tecido Conjuntivo/antagonistas & inibidores , Ratos , Masculino , Edema Pulmonar/etiologia , Edema Pulmonar/metabolismo , Anticorpos Neutralizantes/farmacologia , Ratos Sprague-Dawley , Pulmão/patologia , Pulmão/metabolismo , Modelos Animais de Doenças , Receptor para Produtos Finais de Glicação Avançada/metabolismo , Receptor para Produtos Finais de Glicação Avançada/antagonistas & inibidores
7.
J Am Heart Assoc ; 13(11): e031632, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38804208

RESUMO

BACKGROUND: Pregnancy in patients with pulmonary hypertension (PH) is associated with a heightened risk of medical complications including right heart failure, pulmonary edema, and arrhythmias. Our study investigated the association between PH and these complications during delivery. METHODS AND RESULTS: The National Inpatient Sample was used to identify delivery hospitalizations from 2011 to 2020. Multivariable logistic regression was performed to study the association of PH with the primary outcomes of in-hospital medical and obstetric complications. A total of 37 482 207 delivery hospitalizations in women ≥18 years of age were identified, of which 9593 patients had PH. Pregnant patients with PH had higher incidence of complications during delivery including preeclampsia/eclampsia, arrhythmias, and pulmonary edema among others, compared with those without PH. Pregnant patients with PH also had a higher incidence of in-hospital mortality compared with those without PH (0.51% versus 0.007%). In propensity-matched analyses, PH was still significantly associated with a higher risk of in-hospital mortality (odds ratio [OR], 5.02 [95% CI, 1.82-13.90]; P=0.001), pulmonary edema (OR, 9.11 [95% CI, 6.34-13.10]; P<0.001), peripartum cardiomyopathy (OR, 1.85 [95% CI, 1.37-2.50]; P<0.001), venous thromboembolism (OR, 12.60 [95% CI, 6.04-26.10]; P<0.001), cardiac arrhythmias (OR, 6.11 [95% CI, 4.97-7.53]; P<0.001), acute kidney injury (OR, 3.72 [95% CI, 2.86-4.84]; P<0.001), preeclampsia/eclampsia (OR, 2.24 [95% CI, 1.95-2.58]; P<0.001), and acute coronary syndrome (OR, 2.01 [95% CI, 1.06-3.80]; P=0.03), compared with pregnant patients without PH. CONCLUSIONS: Delivery hospitalizations in patients with PH are associated with a high risk of mortality, pulmonary edema, peripartum cardiomyopathy, venous thromboembolism, arrhythmias, acute kidney injury, preeclampsia/eclampsia, and acute coronary syndrome.


Assuntos
Mortalidade Hospitalar , Hospitalização , Hipertensão Pulmonar , Complicações Cardiovasculares na Gravidez , Humanos , Feminino , Gravidez , Hipertensão Pulmonar/epidemiologia , Hipertensão Pulmonar/mortalidade , Hipertensão Pulmonar/terapia , Adulto , Estados Unidos/epidemiologia , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Complicações Cardiovasculares na Gravidez/epidemiologia , Complicações Cardiovasculares na Gravidez/terapia , Mortalidade Hospitalar/tendências , Incidência , Adulto Jovem , Fatores de Risco , Estudos Retrospectivos , Parto Obstétrico/estatística & dados numéricos , Parto Obstétrico/efeitos adversos , Edema Pulmonar/epidemiologia , Edema Pulmonar/etiologia , Edema Pulmonar/mortalidade , Arritmias Cardíacas/epidemiologia , Arritmias Cardíacas/terapia , Arritmias Cardíacas/mortalidade , Medição de Risco
8.
J Pharmacol Sci ; 155(3): 94-100, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38797538

RESUMO

Interleukin (IL-19) belongs to the IL-10 family of cytokines and plays diverse roles in inflammation, cell development, viral responses, and lipid metabolism. Acute lung injury (ALI) is a severe respiratory condition associated with various diseases, including severe pneumonia, sepsis, and trauma, lacking established treatments. However, the role of IL-19 in acute inflammation of the lungs is unknown. We reported the impact of IL-19 functional deficiency in mice crossed with an ALI model using HCl. Lungs damages, neutrophil infiltration, and pulmonary edema induced by HCl were significantly worse in IL-19 knockout (KO) mice than in wild-type (WT) mice. mRNA expression levels of C-X-C motif chemokine ligand 1 (CXCL1) and IL-6 in the lungs were significantly higher in IL-19 KO mice than in WT mice. Little apoptosis was detected in lung injury in WT mice, whereas apoptosis was observed in exacerbated area of lung injury in IL-19 KO mice. These results are the first to show that IL-19 is involved in acute inflammation of the lungs, suggesting a novel molecular mechanism in acute respiratory failures. If it can be shown that neutrophils have IL-19 receptors and that IL-19 acts directly on them, it would be a novel drug target.


Assuntos
Lesão Pulmonar Aguda , Ácido Clorídrico , Interleucinas , Camundongos Knockout , Animais , Lesão Pulmonar Aguda/etiologia , Lesão Pulmonar Aguda/patologia , Lesão Pulmonar Aguda/genética , Interleucinas/genética , Interleucinas/metabolismo , Camundongos Endogâmicos C57BL , Interleucina-6/metabolismo , Interleucina-6/genética , Modelos Animais de Doenças , Infiltração de Neutrófilos , Quimiocina CXCL1/genética , Quimiocina CXCL1/metabolismo , Masculino , Pulmão/patologia , Pulmão/metabolismo , Apoptose/genética , Apoptose/efeitos dos fármacos , Camundongos , Neutrófilos , Edema Pulmonar/etiologia , Expressão Gênica
9.
Am J Case Rep ; 25: e943645, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38711258

RESUMO

BACKGROUND Neurogenic pulmonary edema (NPE) is a rare complication of neurological insults, such as traumatic brain injury and intracranial hemorrhage, in children. NPE frequently accompanies left ventricular (LV) dysfunction mediated via central catecholamine surge and inflammation. A high serum natriuretic (BNP) level was prolonged even after the LV contraction was improved in this case with severe myocardial injury. The overloading stress to the LV wall can last several days over the acute phase of NPE. CASE REPORT A 6-year-old boy developed NPE after the removal of a brain tumor in the cerebellar vermis, which was complicated by hydrocephalus. Simultaneously, he experienced LV dysfunction involving reduced global contraction with severe myocardial injury diagnosed by abnormally elevated cardiac troponin I level (1611.6 pg/ml) combined with a high serum BNP level (2106 pg/ml). He received mechanical ventilation for 4 days until the improvement of his pulmonary edema in the Intensive Care Unit (ICU). On the next day, after the withdrawal of mechanical ventilation, he was discharged from the ICU to the pediatric unit. Although the LV contraction was restored to an almost normal range in the early period, it took a total of 16 days for the serum BNP level to reach an approximate standard range (36.9 pg/ml). CONCLUSIONS Even in a pediatric patient with NPE, we recommend careful monitoring of the variation of cardiac biomarkers such as BNP until confirmation of return to an approximate normal value because of the possible sustained overloading stress to the LV wall.


Assuntos
Edema Pulmonar , Humanos , Masculino , Edema Pulmonar/etiologia , Criança , Disfunção Ventricular Esquerda/etiologia , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/cirurgia , Troponina I/sangue , Complicações Pós-Operatórias , Peptídeo Natriurético Encefálico/sangue
10.
Int J Cardiol ; 409: 132205, 2024 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-38795974

RESUMO

BACKGROUND: Outpatient monitoring of pulmonary congestion in heart failure (HF) patients may reduce hospitalization rates. This study tested the feasibility of non-invasive high-frequency bioelectrical impedance analysis (HF-BIA) for estimating lung fluid status. METHODS: This prospective study included 70 participants: 50 with acute HF (HF group) and 20 without HF (control group). All participants underwent a supine chest CT scan to measure lung fluid content with lung density analysis software. Concurrently, direct segmental multi-frequency BIA was performed to assess the edema index (EI) of the trunk, entire body, and extremities. RESULTS: The correlation coefficients between lung fluid content and EI measured using HF-BIA were r = 0.566 (p < 0.001) and r = 0.550 (p < 0.001) for the trunk and whole body, respectively. In the HF group, the trunk EI (0.402 ± 0.015) and whole body EI (0.402 ± 0.016) were significantly higher than those of the control group (trunk EI, 0.383 ± 0.007; whole body EI, 0.383 ± 0.007; all p < 0.001). The lung fluid content was significantly higher in the HF than that in the control group (23.7 ± 5.3 vs. 15.5 ± 2.8%, p < 0.001). The log value of NT pro-BNP was significantly correlated with trunk EI (r = 0.688, p < 0.001) and whole-body EI (r = 0.675, p < 0.001) measured by HF-BIA, and the lung fluid content analyzed by CT (r = 0.686, p < 0.001). CONCLUSIONS: BIA-based EI measurements of the trunk and whole body significantly correlated with lung fluid content and NT pro-BNP levels. Non-invasive BIA could be a promising screening tool for lung fluid status monitoring in acute HF patients.


Assuntos
Impedância Elétrica , Insuficiência Cardíaca , Humanos , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/metabolismo , Projetos Piloto , Masculino , Feminino , Estudos Prospectivos , Pessoa de Meia-Idade , Idoso , Doença Aguda , Pulmão/fisiopatologia , Pulmão/diagnóstico por imagem , Pulmão/metabolismo , Edema Pulmonar/fisiopatologia , Edema Pulmonar/diagnóstico , Edema Pulmonar/diagnóstico por imagem , Edema Pulmonar/metabolismo
11.
Microvasc Res ; 154: 104694, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38723844

RESUMO

INTRODUCTION: Critical illness is associated with organ failure, in which endothelial hyperpermeability and tissue edema play a major role. The endothelial angiopoietin/Tie2 system, a regulator of endothelial permeability, is dysbalanced during critical illness. Elevated circulating angiopoietin-2 and decreased Tie2 receptor levels are reported, but it remains unclear whether they cause edema independent of other critical illness-associated alterations. Therefore, we have studied the effect of angiopoietin-2 administration and/or reduced Tie2 expression on microvascular leakage and edema under normal conditions. METHODS: Transgenic male mice with partial deletion of Tie2 (heterozygous exon 9 deletion, Tie2+/-) and wild-type controls (Tie2+/+) received 24 or 72 pg/g angiopoietin-2 or PBS as control (n = 12 per group) intravenously. Microvascular leakage and edema were determined by Evans blue dye (EBD) extravasation and wet-to-dry weight ratio, respectively, in lungs and kidneys. Expression of molecules related to endothelial angiopoietin/Tie2 signaling were determined by ELISA and RT-qPCR. RESULTS: In Tie2+/+ mice, angiopoietin-2 administration increased EBD extravasation (154 %, p < 0.05) and wet-to-dry weight ratio (133 %, p < 0.01) in lungs, but not in the kidney compared to PBS. Tie2+/- mice had higher pulmonary (143 %, p < 0.001), but not renal EBD extravasation, compared to wild-type control mice, whereas a more pronounced wet-to-dry weight ratio was observed in lungs (155 %, p < 0.0001), in contrast to a minor higher wet-to-dry weight ratio in kidneys (106 %, p < 0.05). Angiopoietin-2 administration to Tie2+/- mice did not further increase pulmonary EBD extravasation, pulmonary wet-to-dry weight ratio, or renal wet-to-dry weight ratio. Interestingly, angiopoietin-2 administration resulted in an increased renal EBD extravasation in Tie2+/- mice compared to Tie2+/- mice receiving PBS. Both angiopoietin-2 administration and partial deletion of Tie2 did not affect circulating angiopoietin-1, soluble Tie2, VEGF and NGAL as well as gene expression of angiopoietin-1, -2, Tie1, VE-PTP, ELF-1, Ets-1, KLF2, GATA3, MMP14, Runx1, VE-cadherin, VEGFα and NGAL, except for gene and protein expression of Tie2, which was decreased in Tie2+/- mice compared to Tie2+/+ mice. CONCLUSIONS: In mice, the microvasculature of the lungs is more vulnerable to angiopoietin-2 and partial deletion of Tie2 compared to those in the kidneys with respect to microvascular leakage and edema.


Assuntos
Angiopoietina-2 , Permeabilidade Capilar , Pulmão , Receptor TIE-2 , Animais , Receptor TIE-2/metabolismo , Receptor TIE-2/genética , Angiopoietina-2/metabolismo , Angiopoietina-2/genética , Masculino , Pulmão/irrigação sanguínea , Pulmão/metabolismo , Pulmão/patologia , Rim/irrigação sanguínea , Rim/metabolismo , Transdução de Sinais , Camundongos Knockout , Camundongos , Camundongos Endogâmicos C57BL , Edema Pulmonar/metabolismo , Edema Pulmonar/genética , Edema Pulmonar/patologia , Edema Pulmonar/induzido quimicamente , Edema Pulmonar/fisiopatologia , Modelos Animais de Doenças , Edema/metabolismo , Camundongos Transgênicos , Ribonuclease Pancreático
12.
Rev Clin Esp (Barc) ; 224(6): 337-345, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38697610

RESUMO

BACKGROUND AND OBJECTIVES: cardiovascular changes during pregnancy carry greater risk in heart disease. We analyze cardiovascular, obstetric and perinatal adverse effects associated with congenital and acquired heart disease during pregnancy and postpartum. MATERIALS AND METHODS: Cross-sectional and retrospective study, which included the 2017-2023 registry of pregnant or postpartum patients hospitalised with diagnosis of congenital or acquired heart disease. Adverse events (heart failure, stroke, acute pulmonary edema, maternal death, obstetric haemorrhage, prematurity and perinatal death) were compared with the clinical variables and the implemented treatment. RESULTS: 112 patients with a median age of 28 years (range 15-44) were included. Short circuits predominated 28 (25%). Thirty-six patients (32%) were classified in class IV of the modified WHO scale for maternal cardiovascular risk. Heart failure occurred in 39 (34.8%), acute lung edema 12 (10.7%), stroke 2 (1.8%), maternal death 5 (4.5%), obstetric haemorrhage 4 (3.6%), prematurity 50 (44.5%) and perinatal death 6 (5.4%). Shunts were associated with prematurity (adjusted odds ratio 4; 95% CI: 1.5-10, p = 0.006). Peripartum cardiomyopathy represented higher risk of pulmonary edema (adjusted OR 34; 95% CI: 6-194, p = 0.001) and heart failure (adjusted OR 16; 95% CI: 3-84, p = 0.001). An increased risk of obstetric haemorrhage was observed in patients with prosthetic valves (adjusted OR 30; 95% CI: 1.5-616, p = 0.025) and with the use of acetylsalicylic acid (adjusted OR 14; 95% CI: 1.2-16, p = 0.030). Furthermore, the latter was associated with perinatal death (adjusted OR 9; 95% CI: 1.4-68, p = 0.021). CONCLUSIONS: severe complications were found during pregnancy and postpartum in patients with heart disease, which is why preconception evaluation and close surveillance are vital.


Assuntos
Cardiopatias , Complicações Cardiovasculares na Gravidez , Transtornos Puerperais , Humanos , Feminino , Gravidez , Estudos Retrospectivos , Adulto , Estudos Transversais , Complicações Cardiovasculares na Gravidez/epidemiologia , Adulto Jovem , Adolescente , Transtornos Puerperais/epidemiologia , Transtornos Puerperais/etiologia , Recém-Nascido , Edema Pulmonar/epidemiologia , Edema Pulmonar/etiologia , Período Pós-Parto
14.
Nitric Oxide ; 146: 58-63, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38583684

RESUMO

Nitric oxide was first identified as a novel and effective treatment for persistent pulmonary hypertension of the newborn (PPHN), and has since been found to be efficacious in treating acute respiratory distress syndrome (ARDS) and pulmonary hypertension. Physicians and researchers have also found it shows promise in resource-constrained settings, both within and outside of the hospital, such as in high altitude pulmonary edema (HAPE) and COVID-19. The treatment has been well tolerated in these settings, and is both efficacious and versatile when studied across a variety of clinical environments. Advancements in inhaled nitric oxide continue, and the gas is worthy of investigation as physicians contend with new respiratory and cardiovascular illnesses, as well as unforeseen logistical challenges.


Assuntos
COVID-19 , Óxido Nítrico , Humanos , Óxido Nítrico/administração & dosagem , Óxido Nítrico/metabolismo , Óxido Nítrico/uso terapêutico , SARS-CoV-2 , Doença da Altitude/tratamento farmacológico , Síndrome da Persistência do Padrão de Circulação Fetal/tratamento farmacológico , Hipertensão Pulmonar/tratamento farmacológico , Administração por Inalação , Edema Pulmonar
15.
BMC Vet Res ; 20(1): 145, 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38641793

RESUMO

BACKGROUND: Human records describe pulmonary edema as a life-threatening complication of electric shock. Successful management requires prompt recognition and intensive care. However, in companion animals, electrocutions are rarely reported, even though domestic environments are full of electrical devices and there is always the possibility of accidental injury. Therefore, it is important for veterinarians to know more about this condition in order to achieve successful patient outcomes. CASE PRESENTATION: A 3-month-old male Labrador Retriever was presented with a history of transient loss of consciousness after chewing on a household electrical cord. On admission, the puppy showed an orthopneic position with moderate respiratory distress. Supplemental oxygen via nasal catheter was provided, but the patient showed marked worsening of respiratory status. Point-of-care ultrasound exams suggested neurogenic pulmonary edema due to electrical shock close to the central nervous system and increased B-lines without evidence of cardiac abnormalities. Mechanical ventilation of the patient was initiated using volume-controlled mode with a tidal volume of 9 to 15 ml/kg until reaching an end-tidal carbon dioxide ≤ 40 mm Hg, followed by a stepwise lung-recruitment maneuver in pressure-controlled mode with increases of the peak inspiratory pressure (15 to 20 cm H2O) and positive end-expiratory pressure (3 to 10 cm H2O) for 30 min, and return to volume-controlled mode with a tidal volume of 15 ml/kg until reaching a peripheral oxygen saturation ≥ 96%. Weaning from the ventilator was achieved in six hours, and the patient was discharged two days after admission without neurological or respiratory deficits. CONCLUSIONS: We present a rather unusual case of a neurogenic pulmonary edema subsequent to accidental electrocution in a dog. Timely diagnosis by ultrasound and mechanical ventilation settings are described. Our case highlights that pulmonary edema should be considered a potentially life-threatening complication of electrical shock in small animal emergency and critical care medicine.


Assuntos
Doenças do Cão , Traumatismos por Eletricidade , Edema Pulmonar , Síndrome do Desconforto Respiratório , Animais , Cães , Masculino , Doenças do Cão/etiologia , Doenças do Cão/terapia , Traumatismos por Eletricidade/complicações , Traumatismos por Eletricidade/terapia , Traumatismos por Eletricidade/veterinária , Pulmão , Edema Pulmonar/etiologia , Edema Pulmonar/terapia , Edema Pulmonar/veterinária , Respiração Artificial/veterinária , Síndrome do Desconforto Respiratório/veterinária
16.
Malays J Pathol ; 46(1): 51-62, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38682844

RESUMO

Small animal models play an important role in investigating and revealing the molecular determinants and mechanisms underlying neuro-virulence of enterovirus A71 (EV-A71). In our previous study, we successfully developed two mouse cell-line replication competent EV-A71 strains (EV71:TLLm and EV71:TLLmv) which were capable of inducing neuro-invasion in BALB/c mice. The more virulent EV71:TLLmv exhibited ability to induce acute encephalomyelitis accompanied by neurogenic pulmonary oedema. EV71:TLLcho virus strain was generated from EV71:TLLm by a series of passages in CHO-K1 cells. EV71:TLLcho demonstrated a broader range of infectivity across various mammalian cell lines and exhibited complete cytopathic effects (CPE) within 48 hours post-inoculation in comparison to EV71:TLLm or EV71:TLLmv. EV71:TLLcho consistently yielded higher levels of viral replication at all time points examined. In comparison to EV71:TLLm, EV71:TLLcho consistently induced more severe disease and increased mortality in one-week old BALB/c mice. However, unlike mice challenged with EV71:TLLmv, none of the mice challenged with EV71:TLLcho progressed to severe acute encephalomyelitis and developed neurogenic pulmonary oedema.


Assuntos
Modelos Animais de Doenças , Enterovirus Humano A , Infecções por Enterovirus , Camundongos Endogâmicos BALB C , Edema Pulmonar , Animais , Edema Pulmonar/virologia , Edema Pulmonar/patologia , Infecções por Enterovirus/complicações , Infecções por Enterovirus/virologia , Camundongos , Replicação Viral , Humanos
17.
Curr Sports Med Rep ; 23(4): 124-129, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38578489

RESUMO

ABSTRACT: Swimming-induced pulmonary edema (SIPE) is a rare but life-threatening acute illness that can occur in otherwise healthy athletes and individuals. Also known as immersion pulmonary edema, SIPE presents in swimmers, snorkelers, and SCUBA divers. It occurs in persons under heavy exertion in cold water temperatures, leading to coughing, shortness of breath, and sometimes blood-tinged sputum. Under these conditions, there is increased pulmonary vascular pressure, which may ultimately lead to pulmonary edema. This article synthesizes the latest data on the prevalence, pathophysiology, etiology, risks, short- and long-term complications, and the efficacy of supportive medical treatment interventions.


Assuntos
Mergulho , Edema Pulmonar , Humanos , Natação , Edema Pulmonar/diagnóstico , Edema Pulmonar/etiologia , Edema Pulmonar/terapia , Temperatura Baixa , Dispneia/complicações , Mergulho/efeitos adversos
19.
Exp Gerontol ; 191: 112435, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38636569

RESUMO

Oxygen supplementation is a widely used treatment for ICU patients. However, it can lead to hyperoxia, which in turn can result in oxidative stress, cardiac remodeling, and even mortality. This paper expands upon previous research conducted by our lab to establish time-dependent cardiac changes under hyperoxia. In this study, both young and aged mice (male and female) underwent 72 h of hyperoxia exposure and were monitored at 24-hour intervals for cardiac electrophysiological and functional parameters using ECG and electrocardiogram data. Our analysis showed that young male mice experienced significant weight loss as well as significant lung edema by 48 h. Although young male mice were highly susceptible to physical changes, they were resistant to early cardiac functional and electrophysiological changes compared to the other groups. Both young and aged female and aged males developed functional impairments by 24 h of hyperoxia exposure. Furthermore, sex and age differences were noted in the onset of electrophysiological changes. While some groups could resist early cardiac remodeling, our data suggests that 72 h of hyperoxia exposure is sufficient to induce significant cardiac remodeling across all age and sex groups. Our data establishes that time-dependent cardiac changes due to oxygen supplementation can have devastating consequences even with short exposure periods. These findings can aid in developing clinical practices for individuals admitted to the ICU by elucidating the impact of aging, sex, and length of stay under mechanical ventilation to limit hyperoxia-induced cardiac remodeling.


Assuntos
Modelos Animais de Doenças , Hiperóxia , Animais , Hiperóxia/fisiopatologia , Feminino , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fatores Sexuais , Eletrocardiografia , Fatores Etários , Envelhecimento/fisiologia , Edema Pulmonar/fisiopatologia , Oxigenoterapia/métodos , Coração/fisiopatologia , Coração/fisiologia , Fatores de Tempo , Remodelação Ventricular/fisiologia , Estresse Oxidativo
20.
J Sci Med Sport ; 27(7): 454-457, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38609817

RESUMO

Pre-participation screening and management of congenital cardiac valvulopathy in competitive athletes can be challenging, particularly within the context of ultra-endurance disciplines. A 55-year-old female athlete without a reported history of cardiac disease exhibited clinical signs of cardiogenic pulmonary edema during a 156 km ultra-trail race. The echocardiographic assessment revealed the presence of a parachute mitral valve, with no evidence of mitral stenosis or regurgitation at rest, but it demonstrated severe dynamic mitral stenosis during exercise. In competitive athletes, the detection of rare valvulopathy should prompt a comprehensive cardiac evaluation aimed at assessing the potential for dynamic valvular dysfunction.


Assuntos
Ecocardiografia , Estenose da Valva Mitral , Valva Mitral , Humanos , Feminino , Pessoa de Meia-Idade , Estenose da Valva Mitral/diagnóstico por imagem , Valva Mitral/diagnóstico por imagem , Valva Mitral/anormalidades , Edema Pulmonar/diagnóstico por imagem , Atletas
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...