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[PMID]: 28686711 [Au] Autor: Zhalyalov AS; Panteleev MA; Gracheva MA; Ataullakhanov FI; Shibeko AM [Ad] Endereço: Center for Theoretical Problems of Physicochemical Pharmacology RAS, Moscow, Russia. [Ti] Título: Co-ordinated spatial propagation of blood plasma clotting and fibrinolytic fronts. [So] Source: PLoS One;12(7):e0180668, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Fibrinolysis is a cascade of proteolytic reactions occurring in blood and soft tissues, which functions to disintegrate fibrin clots when they are no more needed. In order to elucidate its regulation in space and time, fibrinolysis was investigated using an in vitro reaction-diffusion experimental model of blood clot formation and dissolution. Clotting was activated by a surface with immobilized tissue factor in a thin layer of recalcified blood plasma supplemented with tissue plasminogen activator (TPA), urokinase plasminogen activator or streptokinase. Formation and dissolution of fibrin clot was monitored by videomicroscopy. Computer systems biology model of clot formation and lysis was developed for data analysis and experimental planning. Fibrin clot front propagated in space from tissue factor, followed by a front of clot dissolution propagating from the same source. Velocity of lysis front propagation linearly depended on the velocity clotting front propagation (correlation r2 = 0.91). Computer model revealed that fibrin formation was indeed the rate-limiting step in the fibrinolysis front propagation. The phenomenon of two fronts which switched the state of blood plasma from liquid to solid and then back to liquid did not depend on the fibrinolysis activator. Interestingly, TPA at high concentrations began to increase lysis onset time and to decrease lysis propagation velocity, presumably due to plasminogen depletion. Spatially non-uniform lysis occurred simultaneously with clot formation and detached the clot from the procoagulant surface. These patterns of spatial fibrinolysis provide insights into its regulation and might explain clinical phenomena associated with thrombolytic therapy. [Mh] Termos MeSH primário: Coagulação Sanguínea/genética Fibrinólise/genética Terapia Trombolítica [Mh] Termos MeSH secundário: Simulação por Computador Fibrina/genética Fibrina/metabolismo Seres Humanos Plasminogênio/metabolismo Estreptoquinase/sangue Tromboplastina/metabolismo Ativador de Plasminogênio Tecidual/sangue Ativador de Plasminogênio Tipo Uroquinase/sangue [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 9001-31-4 (Fibrin); 9001-91-6 (Plasminogen); 9035-58-9 (Thromboplastin); EC 3.4.- (Streptokinase); EC 3.4.21.68 (PLAT protein, human); EC 3.4.21.68 (Tissue Plasminogen Activator); EC 3.4.21.73 (Urokinase-Type Plasminogen Activator) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171006 [Lr] Data última revisão: 171006 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170708 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0180668

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[PMID]: 28247197 [Au] Autor: Keramati M; Aslani MM; Khatami S; Roohvand F [Ad] Endereço: Pilot of Nano-biotechnology Department, Pasteur Institute of Iran, Tehran, Iran. [Ti] Título: Sequence and kinetic analyses of streptokinase from two group G streptococci with high fibrin-dependent plasminogen activities and the identification of novel altered amino acids as potential hot spots. [So] Source: Biotechnol Lett;39(6):889-895, 2017 Jun. [Is] ISSN: 1573-6776 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To gain insights on the degree of heterogeneity and kinetic differences of streptokinase (SK) from group G (SKG) Streptococci compared with standard SK from group C (SKC) and identification of potentially contributing critical residues (hotspots). RESULTS: DNA and sequencing analyses confirmed the proper construction of all SK encoding vectors (two SKGs and one standard SKC). SDS-PAGE and western blot analyses confirmed the expression and proper purification of the recombinant SKs from E.coli with the expected size of 47 kDa. Kinetic analyses of two SKGs, compared with SKC, showed higher levels of specific [(×10 IU/mg) of 725 and 715 vs. 536] and fibrin-dependent proteolytic activities [Kcat/K (min /µM) of 37 and 30 vs. 23], accompanied by declined fibrin-independent amidolytic activities [Kcat/K (min /mM) of 109 and 84 vs. 113], respectively. Sequence alignments identified 10 novel residual substitutions scattered in SKα (I33F, R45Q, SKG132, A47D, and G55 N), SKß (N228 K, F287I), and SKγ domains (L335 V, V396A, T403S) of SKGs, as potential hotspots. CONCLUSION: The residue substitutions identified might critically contribute as hot spots to different kinetic parameters of SKGs and might assist in further elucidation of structure/function relations and rational design of SKs with improved (fibrin-dependent) therapeutic properties. [Mh] Termos MeSH primário: Aminoácidos/química Proteínas de Bactérias/química Proteínas de Bactérias/metabolismo Streptococcus/enzimologia Estreptoquinase/química Estreptoquinase/metabolismo [Mh] Termos MeSH secundário: Aminoácidos/metabolismo Proteínas de Bactérias/genética Clonagem Molecular Escherichia coli Fibrina/metabolismo Cinética Plasminogênio/metabolismo Proteínas Recombinantes/química Proteínas Recombinantes/genética Proteínas Recombinantes/metabolismo Análise de Sequência de Proteína Streptococcus/genética Estreptoquinase/genética [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Amino Acids); 0 (Bacterial Proteins); 0 (Recombinant Proteins); 9001-31-4 (Fibrin); 9001-91-6 (Plasminogen); EC 3.4.- (Streptokinase) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171027 [Lr] Data última revisão: 171027 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170302 [St] Status: MEDLINE [do] DOI: 10.1007/s10529-017-2310-9

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[PMID]: 28125743 [Au] Autor: Huish S; Thelwell C; Longstaff C [Ad] Endereço: Component development laboratory, NHS Blood and Transplant, Cambridge Donor Centre, Cambridge, United Kingdom. [Ti] Título: Activity Regulation by Fibrinogen and Fibrin of Streptokinase from Streptococcus Pyogenes. [So] Source: PLoS One;12(1):e0170936, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Streptokinase is a virulence factor of streptococci and acts as a plasminogen activator to generate the serine protease plasmin which promotes bacterial metastasis. Streptokinase isolated from group C streptococci has been used therapeutically as a thrombolytic agent for many years and its mechanism of action has been extensively studied. However, group A streptococci are associated with invasive and potentially fatal infections, but less detail is available on the mechanism of action of streptokinase from these bacteria. We have expressed recombinant streptokinase from a group C strain to investigate the therapeutic molecule (here termed rSK-H46A) and a molecule isolated from a cluster 2a strain from group A (rSK-M1GAS) which is known to produce the fibrinogen binding, M1 protein, and is associated with life-threatening disease. Detailed enzyme kinetic models have been prepared which show how fibrinogen-streptokinase-plasminogen complexes regulate plasmin generation, and also the effect of fibrin interactions. As is the case with rSK-H46A our data with rSK-M1GAS support a "trigger and bullet" mechanism requiring the initial formation of SK•plasminogen complexes which are replaced by more active SK•plasmin as plasmin becomes available. This model includes the important fibrinogen interactions that stimulate plasmin generation. In a fibrin matrix rSK-M1GAS has a 24 fold higher specific activity than the fibrin-specific thrombolytic agent, tissue plasminogen activator, and 15 fold higher specific activity than rSK-H46A. However, in vivo fibrin specificity would be undermined by fibrinogen stimulation. Given the observed importance of M1 surface receptors or released M1 protein to virulence of cluster 2a strain streptococci, studies on streptokinase activity regulation by fibrin and fibrinogen may provide additional routes to addressing bacterial invasion and infectious diseases. [Mh] Termos MeSH primário: Fibrina/metabolismo Fibrinogênio/metabolismo Modelos Teóricos Streptococcus pyogenes/metabolismo Estreptoquinase/metabolismo [Mh] Termos MeSH secundário: Plasminogênio/metabolismo [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 9001-31-4 (Fibrin); 9001-32-5 (Fibrinogen); 9001-91-6 (Plasminogen); EC 3.4.- (Streptokinase) [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170814 [Lr] Data última revisão: 170814 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170127 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0170936

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[PMID]: 28116631 [Au] Autor: Klegerman ME [Ad] Endereço: Department of Internal Medicine, Division of Cardiovascular Medicine, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, 77054, USA. Melvin.E.Klegerman@uth.tmc.edu. [Ti] Título: Translational initiatives in thrombolytic therapy. [So] Source: Front Med;11(1):1-19, 2017 Mar. [Is] ISSN: 2095-0225 [Cp] País de publicação: China [La] Idioma: eng [Ab] Resumo: Once thrombi have formed as part of the pathology defining myocardial infarction, ischemic stroke, peripheral arterial disease, deep venous thrombosis or other embolic disorders, the only clinically meaningful thrombolytic agents available for reversing the thrombogenic process are various plasminogen activators. These agents are enzymes that reverse fibrin polymerization underlying the coagulation process by converting endogenous plasminogen to plasmin, which cleaves the fibrin network to form increasingly smaller protein fragments, a process known as fibrinolysis. For the most part, the major clinically used thrombolytics, tissue plasminogen activator, urokinase and streptokinase, as well as the experimentally investigated agent staphylokinase, are the products of recombinant DNA technology, which permits molecular optimization of clinical efficacy. In all cases of molecular optimization and targeting, however, the primary challenge of thrombolytic therapy remains hemorrhagic side effects, which are especially devastating when they occur intracerebrally. Currently, the best strategy to ameliorate this adverse effect is nanoparticulate encapsulation or complexation, and many strategies of this sort are being actively pursued. This review summarizes the variety of targeted and untargeted thrombolytic formulations that have been investigated in preclinical studies. [Mh] Termos MeSH primário: Fibrinolíticos/administração & dosagem Terapia Trombolítica/métodos Trombose/tratamento farmacológico Ativador de Plasminogênio Tecidual/administração & dosagem [Mh] Termos MeSH secundário: Animais Cães Fibrinólise Seres Humanos Metaloendopeptidases/administração & dosagem Camundongos Infarto do Miocárdio/complicações Estreptoquinase/administração & dosagem Acidente Vascular Cerebral/complicações Trombose/complicações Trombose/diagnóstico por imagem Ultrassonografia Ativador de Plasminogênio Tipo Uroquinase/administração & dosagem [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Fibrinolytic Agents); EC 3.4.- (Streptokinase); EC 3.4.21.68 (Tissue Plasminogen Activator); EC 3.4.21.73 (Urokinase-Type Plasminogen Activator); EC 3.4.24.- (Metalloendopeptidases); EC 3.4.24.29 (auR protein, Staphylococcus aureus) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 171105 [Lr] Data última revisão: 171105 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170125 [St] Status: MEDLINE [do] DOI: 10.1007/s11684-017-0497-8

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[PMID]: 27900590 [Au] Autor: Nowak W; Trelinski J; Chojnowski K; Matczak J; Robak M; Misiewicz M; Nowak P [Ad] Endereço: Department of Hematology, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland. [Ti] Título: Assessment of oxidative/nitrative modifications of plasma proteins, selected ROTEM parameters and kinetics of fibrinogen polymerization in patients with multiple myeloma at diagnosis. [So] Source: Med Oncol;34(1):4, 2017 Jan. [Is] ISSN: 1559-131X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Patients with multiple myeloma (MM) are at increased risk of thrombosis. Growing evidence indicates that oxidative and nitrative modifications of proteins, including fibrinogen, may lead to changes in hemostasis. The study compares samples from patients with MM at diagnosis and healthy volunteers with regard to the oxidative/nitrative modifications of proteins, ROTEM and thrombin-catalyzed fibrin polymerization. The content of carbonyl groups in plasma proteins of patients with MM was significantly higher than in controls (2.981 vs. 1.807 nmol/mg of protein, p = 0.005), while no differences were seen in the concentrations of nitrated proteins. Maximum clot firmness readings were significantly higher in the samples of patients than in controls according to FIBTEM test (23.5 vs. 15 mm, p = 0.006). The lag time of the fibrin polymerization process and the velocity of clot lysis (V ) were found to be significantly higher in the group of MM patients than controls. In contrast, no marked differences were identified between studied groups in reference to maximal velocity of fibrin polymerization process (V ), maximal absorbance (A ) and plasmin amidolytic activity values. In conclusion, our study demonstrates that at the time of diagnosis, patients with MM demonstrated greater oxidative stress than healthy volunteers, which is reflected in a higher amount of carbonylated proteins. Some prothrombotic features found in ROTEM tests in MM patients were not confirmed by turbidimetry. [Mh] Termos MeSH primário: Proteínas Sanguíneas/metabolismo Fibrinogênio/metabolismo Mieloma Múltiplo/sangue Estresse Oxidativo/fisiologia [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Biomarcadores Tumorais/sangue Estudos de Casos e Controles Ensaio de Imunoadsorção Enzimática Feminino Seres Humanos Masculino Meia-Idade Mieloma Múltiplo/diagnóstico Mieloma Múltiplo/diagnóstico por imagem Nitrosação Plasminogênio/metabolismo Estreptoquinase/sangue Tromboelastografia/métodos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Biomarkers, Tumor); 0 (Blood Proteins); 9001-32-5 (Fibrinogen); 9001-91-6 (Plasminogen); EC 3.4.- (Streptokinase) [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 171108 [Lr] Data última revisão: 171108 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161201 [St] Status: MEDLINE

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[PMID]: 27696935 [Au] Autor: Adivitiya; Khasa YP [Ad] Endereço: a Department of Microbiology , University of Delhi South Campus , New Delhi , India. [Ti] Título: The evolution of recombinant thrombolytics: Current status and future directions. [So] Source: Bioengineered;8(4):331-358, 2017 07 04. [Is] ISSN: 2165-5987 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Cardiovascular disorders are on the rise worldwide due to alcohol abuse, obesity, hypertension, raised blood lipids, diabetes and age-related risks. The use of classical antiplatelet and anticoagulant therapies combined with surgical intervention helped to clear blood clots during the inceptive years. However, the discovery of streptokinase and urokinase ushered the way of using these enzymes as thrombolytic agents to degrade the fibrin network with an issue of systemic hemorrhage. The development of second generation plasminogen activators like anistreplase and tissue plasminogen activator partially controlled this problem. The third generation molecules, majorly t-PA variants, showed desirable properties of improved stability, safety and efficacy with enhanced fibrin specificity. Plasmin variants are produced as direct fibrinolytic agents as a futuristic approach with targeted delivery of these drugs using liposome technlogy. The novel molecules from microbial, plant and animal origin present the future of direct thrombolytics due to their safety and ease of administration. [Mh] Termos MeSH primário: Fibrinolíticos/administração & dosagem Ativadores de Plasminogênio/administração & dosagem Proteínas Recombinantes/administração & dosagem Estreptoquinase/administração & dosagem Trombose/tratamento farmacológico Ativador de Plasminogênio Tecidual/administração & dosagem Ativador de Plasminogênio Tipo Uroquinase/administração & dosagem [Mh] Termos MeSH secundário: Animais Previsões Seres Humanos Engenharia de Proteínas/métodos Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Fibrinolytic Agents); 0 (Recombinant Proteins); EC 3.4.- (Streptokinase); EC 3.4.21.- (Plasminogen Activators); EC 3.4.21.68 (Tissue Plasminogen Activator); EC 3.4.21.73 (Urokinase-Type Plasminogen Activator) [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171127 [Lr] Data última revisão: 171127 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161005 [St] Status: MEDLINE [do] DOI: 10.1080/21655979.2016.1229718

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[PMID]: 26447199 [Au] Autor: Gündüz S; Özkan M; Yesin M; Kalçik M; Gürsoy MO; Karakoyun S; Astarcioglu MA; Aykan AÇ; Gökdeniz T; Biteker M; Duran NE; Yildiz M [Ad] Endereço: 1 Department of Cardiology, Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey. [Ti] Título: Prolonged Infusions of Low-Dose Thrombolytics in Elderly Patients With Prosthetic Heart Valve Thrombosis. [So] Source: Clin Appl Thromb Hemost;23(3):241-247, 2017 Apr. [Is] ISSN: 1938-2723 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: The outcomes of thrombolytic therapy (TT) in elderly patients with prosthetic valve thrombosis (PVT) have not been evaluated previously. We investigated the outcomes of low-dose and slow infusion TT strategies in elderly patients with PVT. METHODS: Twenty-seven (19 female) patients aged ≥65 years (median: 70 years, range: 65-82 years) were treated with repeated TT agents for PVT. The TT regimens included 24-hour infusion of 1.5 million units of streptokinase in 2 patients, 6-hour infusion of 25 mg recombinant tissue plasminogen activator (t-PA) in 12 patients, and 25-hour infusion of 25 mg t-PA in 13 patients. Treatment success and adverse event rates were assessed. RESULTS: The initial and cumulative success rates were 40.7% and 85.2%, respectively. Adverse events occurred in 6 (22.2%) patients including 4 (14.8%) major (1 death, 1 rethrombosis, and 2 failed TT) and 2 (7.4%) minor (1 transient ischemic attack and 1 access site hematoma) events. Higher thrombus burden (thrombus area ≥1.1 cm by receiver operating characteristics analysis, sensitivity: 83.3%, specificity: 85%, area under the curve: 0.86, P = .008) and New York Heart Association class (0% vs 15.4% vs 25% vs 100% for classes I-IV, respectively, P = .02) predicted adverse events. By multiple variable analysis, thrombus area was the only independent predictor of adverse events (odds ratio: 13.8, 95% confidence interval: 1.02-185, P = .04). CONCLUSION: Slow infusion of low doses of TT agents (mostly t-PA) with repetition is successful and safe in elderly patients with PVT. However, excessive thrombus burden may predict adverse events. [Mh] Termos MeSH primário: Próteses Valvulares Cardíacas/efeitos adversos Terapia Trombolítica/métodos Trombose/tratamento farmacológico [Mh] Termos MeSH secundário: Idoso Idoso de 80 Anos ou mais Relação Dose-Resposta a Droga Avaliação de Medicamentos Feminino Fibrinolíticos/administração & dosagem Fibrinolíticos/efeitos adversos Seres Humanos Masculino Valor Preditivo dos Testes Estreptoquinase/administração & dosagem Terapia Trombolítica/efeitos adversos Trombose/etiologia Trombose/patologia Ativador de Plasminogênio Tecidual/administração & dosagem [Pt] Tipo de publicação: EVALUATION STUDIES; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Fibrinolytic Agents); EC 3.4.- (Streptokinase); EC 3.4.21.68 (Tissue Plasminogen Activator) [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170309 [Lr] Data última revisão: 170309 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 151009 [St] Status: MEDLINE [do] DOI: 10.1177/1076029615609698

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[PMID]: 28368566 [Au] Autor: Barthwal MS; Marwah V; Chopra M; Garg Y; Tyagi R; Kishore K; Vijay A; Dutta V; Katoch CD; Singh S; Bhattacharya D [Ti] Título: A Five-Year Study of Intrapleural Fibrinolytic Therapy in Loculated Pleural Collections. [So] Source: Indian J Chest Dis Allied Sci;58(1):17-20, 2016 Jan-Mar. [Is] ISSN: 0377-9343 [Cp] País de publicação: India [La] Idioma: eng [Ab] Resumo: BACKGROUND: Pleural fluid loculations due to complicated parapneumonic effusion (CPE), empyema, tubercular effusion and traumatic hemothorax can be managed either by video-assisted thoracoscopic surgery (VATS) or intrapleural ibrinolytic therapy (IPFT). The former is more invasive, not easily available and is also more expensive. On the other hand, IPFT is less invasive, cheaper, easily accessible and if used early, in loculated pleural collections, break loculations and early pleural peel, thereby facilitating pleural space drainage. OBJECTIVE: To study the efficacy of IPFT in facilitating pleural space drainage in loculated pleural collections of diverse aetiologies. METHODS: A five-year retrospective, observational study of 200 patients, with loculated pleural collections and failed tube drainage and managed with IPFT was carried out. Responders were defined as those with significant volume of fluid drained and significant radiological resolution. RESULTS: There were 106 (53%) cases of CPE, 59 (29.5%) cases of tubercular effusion, 23 (11.5%) cases of empyema and 12 (6%) cases of hemothorax. Responders were 148 (74%) in number. The distribution of responders as per type of loculated pleural collection was as follows: CPE 88 (83%), tubercular 37 (62.7%), empyema 14 (60.8%) and traumatic hemothorax 11 (91.6%). The adverse effects were mild and included chest pain in six patients and low-grade transient fewer in three cases. CONCLUSIONS: Intrapleural fibrinolytic therapy is a safe and cost-effective option in the management of selected patients with loculated pleural effusions. [Mh] Termos MeSH primário: Fibrinolíticos/uso terapêutico Derrame Pleural/tratamento farmacológico Derrame Pleural/etiologia Estreptoquinase/uso terapêutico Ativador de Plasminogênio Tipo Uroquinase/uso terapêutico [Mh] Termos MeSH secundário: Adulto Tubos Torácicos Criança Pré-Escolar Drenagem Empiema Pleural/complicações Feminino Fibrinolíticos/administração & dosagem Hemotórax/complicações Seres Humanos Masculino Derrame Pleural/diagnóstico por imagem Estudos Retrospectivos Estreptoquinase/administração & dosagem Tuberculose Pulmonar/complicações Ativador de Plasminogênio Tipo Uroquinase/administração & dosagem Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Nm] Nome de substância: 0 (Fibrinolytic Agents); EC 3.4.- (Streptokinase); EC 3.4.21.73 (Urokinase-Type Plasminogen Activator) [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170606 [Lr] Data última revisão: 170606 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170404 [St] Status: MEDLINE

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[PMID]: 27921405 [Au] Autor: Garjani A; Sohrabi B; Movassaghpour AA; Andalib S; Shokri M; Taherkhanchi B; Bagheri B [Ad] Endereço: Department of Pharmacology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. [Ti] Título: Thrombolytic Therapy Up-regulates Inflammatory Mediators Compared to Percutaneous Coronary Intervention (PCI). [So] Source: Iran J Allergy Asthma Immunol;15(4):257-263, 2016 Aug. [Is] ISSN: 1735-1502 [Cp] País de publicação: Iran [La] Idioma: eng [Ab] Resumo: The important role of reperfusion therapies in the treatment of acute myocardial infarction is well documented. However, reperfusion therapies can initiate inflammatory response and may damage the myocardium. The purpose of current study was to compare the effects of percutaneous coronary intervention and thrombolytic therapy on inflammatory markers in the setting of ST elevation myocardial infarction (STEMI). Eighty three patients with STEMI were enrolled in this study. 40 patients underwent percutaneous coronary intervention (PCI), and 43 patients received streptokinase (1.5 million IU) as a main medical reperfusion therapy. Monocyte expression of Toll-like receptor 4 (TLR4),  serum levels of TNF-α and IL-1ß, red cell distribution width (RDW) and C- reactive protein (CRP) were compared between groups at admission time, two hours and four hours after termination of treatment. p<0.05 was considered as statistically significant for all tests. Compared to baseline, both treatments increased monocyte expression of TLR4, serum levels of cytokines and CRP. Compared to PCI, medical reperfusion therapy significantly raised both monocyte expression of TLR4 (39.8±4.7 % vs 49.1±3.6 %, p<0.01), and serum levels of TNF-α (13.2±3.7 pg/ml vs 25.1±2.6pg/mlp<0.05). No effect was seen on RDW levels. Moreover, medical reperfusion therapy caused significant rise in CRP levels (p<0.01). The present study demonstrates that thrombolytic therapy is associated with higher inflammatory responses compared to PCI. Our findings suggest that thrombolytic therapy may increase the likelihood of detrimental effects of reperfusion therapy on the myocardium. [Mh] Termos MeSH primário: Mediadores da Inflamação/sangue Intervenção Coronária Percutânea Infarto do Miocárdio com Supradesnível do Segmento ST/sangue Infarto do Miocárdio com Supradesnível do Segmento ST/terapia Estreptoquinase/administração & dosagem Terapia Trombolítica Regulação para Cima [Mh] Termos MeSH secundário: Idoso Feminino Seres Humanos Mediadores da Inflamação/imunologia Masculino Meia-Idade Infarto do Miocárdio com Supradesnível do Segmento ST/imunologia [Pt] Tipo de publicação: CLINICAL TRIAL; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Inflammation Mediators); EC 3.4.- (Streptokinase) [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170614 [Lr] Data última revisão: 170614 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161207 [St] Status: MEDLINE

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[PMID]: 27751282 [Au] Autor: Abhishek BS; Vijay SC; Avanthi V; Kumar B [Ad] Endereço: Senior Resident in Cardiology, Department of Cardiology, Vydehi Institute of Medical Sciences and Research Center, Whitefield, Bangalore, India. Electronic address: sunil167@yahoo.com. [Ti] Título: Spontaneous psoas hematoma in a case of acute myocardial infarction following streptokinase infusion. [So] Source: Indian Heart J;68 Suppl 2:S18-S21, 2016 Sep. [Is] ISSN: 0019-4832 [Cp] País de publicação: India [La] Idioma: eng [Ab] Resumo: INTRODUCTION: Cardiovascular disorders are the major cause of mortality and morbidity globally as well as in India. In India, where resources are limited and majority of patients pay out of their own pocket, thrombolysis is still done for majority of STEMI cases. CASE SCENARIO: A 48-year-old male patient, nonhypertensive and nondiabetic, came to the ER with history of retrosternal chest pain suggestive of angina at rest. An Electrocardiogram (ECG) revealed ST-segment elevation in the anterior leads. Patient was diagnosed with Acute STEMI and thrombolysis was initiated with STK. The following day, the patient complained of pain in his left groin. On examination, there was a swelling and tenderness in left lower abdomen and inability to extend the hip. A CT scan was done, which showed Psoas muscle hematoma. CONCLUSION: Spontaneous bleed into psoas muscle is a very rare complication of thrombolysis that may require surgical exploration. [Mh] Termos MeSH primário: Hematoma/induzido quimicamente Músculos Psoas Infarto do Miocárdio com Supradesnível do Segmento ST/tratamento farmacológico Estreptoquinase/efeitos adversos Terapia Trombolítica/efeitos adversos [Mh] Termos MeSH secundário: Eletrocardiografia Fibrinolíticos/administração & dosagem Fibrinolíticos/efeitos adversos Hematoma/diagnóstico Seres Humanos Infusões Intravenosas Masculino Meia-Idade Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico Estreptoquinase/administração & dosagem Tomografia Computadorizada por Raios X [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Fibrinolytic Agents); EC 3.4.- (Streptokinase) [Em] Mês de entrada: 1705 [Cu] Atualização por classe: 170902 [Lr] Data última revisão: 170902 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161019 [St] Status: MEDLINE

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