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[PMID]:29442035
[Au] Autor:Incecayir T; Ilbasmis-Tamer S; Tirnaksiz F; Degim T
[Ti] Título:Assessment of the potential drug-drug interaction between carvedilol and clopidogrel mediated through intestinal P-glycoprotein.
[So] Source:Pharmazie;71(8):472-477, 2016 08 01.
[Is] ISSN:0031-7144
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:The most widely prescribed oral antiplatelet agent, clopidogrel, shows high interindividual variability resulting in an increased risk of cardiovascular events in the patients with reduced platelet inhibition. The purpose of this study was to investigate the role of the P-glycoprotein (P-gp) efflux pump in limiting the intestinal permeability of clopidogrel and the effect of a ß-blocker, namely, carvedilol, on its intestinal transport. Effective permeabilities (Peff) of clopidogrel and carvedilol were investigated in the proximal jejunum and distal ileum of rats using an in situ intestinal perfusion model. Peff values of clopidogrel and carvedilol were found to be concentration dependent with decreased Peff values at the low perfusate concentrations. Coperfusion with the P-gp inhibitors verapamil (100 µM) and carvedilol (10 µM) significantly increased the Peff of clopidogrel in the jejunum (8.31±0.20 x 10-5 and 6.98±0.75 x 10-5 vs. 3.60±0.51 x 10-5, respectively) and ileum (9.08±2.19 x 10-5 and 8.35±1.58 x 10-5 vs. 3.85±0.15 x 10-5, respectively). However, at the highest concentration tested (30 µM), clopidogrel exhibited 3 and 1.4 times higher Peff than those of metoprolol, an FDA high permeability reference standard, in the jejunum and ileum, respectively. Overall, this study indicates that the efflux function appears not to have a significant impact on the in vivo intestinal absorption of clopidogrel due to the saturation of P-gp, suggesting no clinically relevant interaction between carvedilol and clopidogrel mediated through P-gp at intestinal level.
[Mh] Termos MeSH primário: Membro 1 da Subfamília B de Cassetes de Ligação de ATP/efeitos dos fármacos
Antagonistas Adrenérgicos beta/farmacologia
Carbazóis/farmacologia
Intestino Delgado/efeitos dos fármacos
Inibidores da Agregação de Plaquetas/farmacologia
Propanolaminas/farmacologia
Ticlopidina/análogos & derivados
[Mh] Termos MeSH secundário: Membro 1 da Subfamília B de Cassetes de Ligação de ATP/antagonistas & inibidores
Animais
Interações Medicamentosas
Absorção Intestinal/efeitos dos fármacos
Intestino Delgado/metabolismo
Masculino
Metoprolol/farmacologia
Perfusão
Permeabilidade/efeitos dos fármacos
Ratos
Ratos Wistar
Ticlopidina/farmacologia
Verapamil/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (ATP-Binding Cassette, Sub-Family B, Member 1); 0 (Adrenergic beta-Antagonists); 0 (Carbazoles); 0 (Platelet Aggregation Inhibitors); 0 (Propanolamines); 0K47UL67F2 (carvedilol); A74586SNO7 (clopidogrel); CJ0O37KU29 (Verapamil); GEB06NHM23 (Metoprolol); OM90ZUW7M1 (Ticlopidine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1691/ph.2016.6059


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[PMID]:29465580
[Au] Autor:Höhne S; Hesse V
[Ti] Título:Standard values for gas-perfusion manometry of the esophagus.
[So] Source:Medicine (Baltimore);97(8):e9910, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The manometry with water-perfused or solid-state catheters is the predominant diagnostic procedure to detect motility disorders of the esophagus. Another method is the manometry using gas-perfused catheters. Although the high-resolution manometry is the method of first choice, the conventional manometry with helium has some advantages: the simple and hygienically unproblematic use and the absence of any artefacts by the perfusion medium compared with water-perfusion, and the considerably lower costs compared with the solid-state catheters. Every method has own normal values because of the specific pressure transmission and the design of the catheter probes. To our knowledge, normal values for gas-perfusion manometry of the esophagus have not yet been published.The esophageal manometry with helium-perfused catheters was performed in 30 healthy volunteers. The main parameters of the esophageal motility and the lower esophageal sphincter were analyzed by liquid and bolus-like swallows and compared with the previous published values in other manometric procedures.The values of the motility in the distal esophagus are consistent; the pressure of the lower esophageal sphincter is generally lower than with other methods. The distal wave amplitude and the propagation velocity are significant higher in the distal esophagus than in the middle. The perfusion medium is well tolerated by the investigated volunteers.
[Mh] Termos MeSH primário: Esôfago/fisiologia
Manometria/métodos
[Mh] Termos MeSH secundário: Adulto
Cateterismo/métodos
Esfíncter Esofágico Inferior/fisiologia
Feminino
Hélio
Seres Humanos
Masculino
Satisfação do Paciente
Perfusão
Pressão
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
206GF3GB41 (Helium)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009910


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[PMID]:29352303
[Au] Autor:Gerli MFM; Guyette JP; Evangelista-Leite D; Ghoshhajra BB; Ott HC
[Ad] Endereço:Center for Regenerative Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
[Ti] Título:Perfusion decellularization of a human limb: A novel platform for composite tissue engineering and reconstructive surgery.
[So] Source:PLoS One;13(1):e0191497, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Muscle and fasciocutaneous flaps taken from autologous donor sites are currently the most utilized approach for trauma repair, accounting annually for 4.5 million procedures in the US alone. However, the donor tissue size is limited and the complications related to these surgical techniques lead to morbidities, often involving the donor sites. Alternatively, recent reports indicated that extracellular matrix (ECM) scaffolds boost the regenerative potential of the injured site, as shown in a small cohort of volumetric muscle loss patients. Perfusion decellularization is a bioengineering technology that allows the generation of clinical-scale ECM scaffolds with preserved complex architecture and with an intact vascular template, from a variety of donor organs and tissues. We recently reported that this technology is amenable to generate full composite tissue scaffolds from rat and non-human primate limbs. Translating this platform to human extremities could substantially benefit soft tissue and volumetric muscle loss patients providing tissue- and species-specific grafts. In this proof-of-concept study, we show the successful generation a large-scale, acellular composite tissue scaffold from a full cadaveric human upper extremity. This construct retained its morphological architecture and perfusable vascular conduits. Histological and biochemical validation confirmed the successful removal of nuclear and cellular components, and highlighted the preservation of the native extracellular matrix components. Our results indicate that perfusion decellularization can be applied to produce human composite tissue acellular scaffolds. With its preserved structure and vascular template, these biocompatible constructs, could have significant advantages over the currently implanted matrices by means of nutrient distribution, size-scalability and immunological response.
[Mh] Termos MeSH primário: Braço/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Engenharia Tecidual/métodos
Tecidos Suporte
[Mh] Termos MeSH secundário: Animais
Braço/anatomia & histologia
Braço/irrigação sanguínea
Reatores Biológicos
Cadáver
Matriz Extracelular/química
Seres Humanos
Imagem Tridimensional
Masculino
Meia-Idade
Perfusão
Ratos
Engenharia Tecidual/instrumentação
Tecidos Suporte/química
Microtomografia por Raio-X
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180121
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191497


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[PMID]:29352276
[Au] Autor:Osadchii OE
[Ad] Endereço:Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
[Ti] Título:Arrhythmogenic drugs can amplify spatial heterogeneities in the electrical restitution in perfused guinea-pig heart: An evidence from assessments of monophasic action potential durations and JT intervals.
[So] Source:PLoS One;13(1):e0191514, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Non-uniform shortening of the action potential duration (APD90) in different myocardial regions upon heart rate acceleration can set abnormal repolarization gradients and promote arrhythmia. This study examined whether spatial heterogeneities in APD90 restitution can be amplified by drugs with clinically proved proarrhythmic potential (dofetilide, quinidine, procainamide, and flecainide) and, if so, whether these effects can translate to the appropriate changes of the ECG metrics of ventricular repolarization, such as JT intervals. In isolated, perfused guinea-pig heart preparations, monophasic action potentials and volume-conducted ECG were recorded at progressively increased pacing rates. The APD90 measured at distinct ventricular sites, as well as the JTpeak and JTend values were plotted as a function of preceding diastolic interval, and the maximum slopes of the restitution curves were determined at baseline and upon drug administration. Dofetilide, quinidine, and procainamide reverse rate-dependently prolonged APD90 and steepened the restitution curve, with effects being greater at the endocardium than epicardium, and in the right ventricular (RV) vs. the left ventricular (LV) chamber. The restitution slope was increased to a greater extent for the JTend vs. the JTpeak interval. In contrast, flecainide reduced the APD90 restitution slope at LV epicardium without producing effect at LV endocardium and RV epicardium, and reduced the JTpeak restitution slope without changing the JTend restitution. Nevertheless, with all agents, these effects translated to the amplified epicardial-to-endocardial and the LV-to-RV non-uniformities in APD90 restitution, paralleled by the increased JTend vs. JTpeak difference in the restitution slope. In summary, these findings suggest that arrhythmic drug profiles are partly attributable to the accentuated regional heterogeneities in APD90 restitution, which can be indirectly determined through ECG assessments of the JTend vs. JTpeak dynamics at variable pacing rates.
[Mh] Termos MeSH primário: Antiarrítmicos/efeitos adversos
Arritmias Cardíacas/induzido quimicamente
Arritmias Cardíacas/fisiopatologia
[Mh] Termos MeSH secundário: Potenciais de Ação/efeitos dos fármacos
Potenciais de Ação/fisiologia
Animais
Fenômenos Eletrofisiológicos
Feminino
Flecainida/efeitos adversos
Cobaias
Técnicas In Vitro
Perfusão
Fenetilaminas/efeitos adversos
Procainamida/efeitos adversos
Quinidina/efeitos adversos
Sulfonamidas/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Arrhythmia Agents); 0 (Phenethylamines); 0 (Sulfonamides); ITX08688JL (Quinidine); K94FTS1806 (Flecainide); L39WTC366D (Procainamide); R4Z9X1N2ND (dofetilide)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180121
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191514


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[PMID]:29342201
[Au] Autor:Neska-Matuszewska M; Bladowska J; Sasiadek M; Zimny A
[Ad] Endereço:Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland.
[Ti] Título:Differentiation of glioblastoma multiforme, metastases and primary central nervous system lymphomas using multiparametric perfusion and diffusion MR imaging of a tumor core and a peritumoral zone-Searching for a practical approach.
[So] Source:PLoS One;13(1):e0191341, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: In conventional MR examinations glioblastomas multiforme (GBMs), metastases and primary CNS lymphomas (PCNSLs) may show very similar appearance. The aim of the study was to evaluate usefulness of multiparametric T2*DSC perfusion and diffusion MR imaging in the preoperative differentiation of these tumors. MATERIAL AND METHODS: Seventy four solitary enhancing tumors (27 GBMs, 30 metastases, 17 PCNSLs) were enrolled in the study. Parameters of cerebral blood volume (rCBV), peak height (rPH), percentage of signal recovery (rPSR) and apparent diffusion coefficient (ADC) were assessed from the tumor core and the peritumoral non-enhancing T2-hyperintense zone. RESULTS: Within the tumor core there were no differences in perfusion and diffusion parameters between GBMs and metastases. Compared to GBMs and metastases, PCNSLs showed significantly lower rCBV and rPH, ADC as well as higher rPSR values. Max rCBV with a cut-off value of 2.18 demonstrated the highest accuracy of 0.98 in differentiating PCNSLs from other tumors. To distinguish GBMs from metastases analysis of the peritumoral zone was performed showing significantly higher rCBV, rPH and lower ADC values in GBMs with the highest accuracy of 0.94 found for max rCBV at a cut-off value of 0.98. CONCLUSIONS: Max rCBV seems to be the most important parameter to differentiate GBMs, metastases and PCNSLs. Analysis of max rCBV within the tumor core enables to distinguish hypoperfused PCNSLs from hyperperfused GBMs and metastases while evaluation of max rCBV within the peritumoral zone is helpful to distinguish GBMs showing peritumoral infiltration from metastases surrounded by pure edema.
[Mh] Termos MeSH primário: Glioblastoma/diagnóstico por imagem
Angiografia por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Idoso
Volume Sanguíneo/fisiologia
Neoplasias Encefálicas/patologia
Diferenciação Celular/genética
Neoplasias do Sistema Nervoso Central
Circulação Cerebrovascular/fisiologia
Diagnóstico Diferencial
Imagem de Difusão por Ressonância Magnética/métodos
Feminino
Glioblastoma/diagnóstico
Glioblastoma/genética
Seres Humanos
Linfoma/diagnóstico por imagem
Linfoma/metabolismo
Masculino
Meia-Idade
Metástase Neoplásica
Sistema Nervoso/patologia
Perfusão
Curva ROC
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191341


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[PMID]:28452921
[Au] Autor:Noda K; Tane S; Haam SJ; D'Cunha J; Hayanga AJ; Luketich JD; Shigemura N
[Ad] Endereço:Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
[Ti] Título:Targeting Circulating Leukocytes and Pyroptosis During Ex Vivo Lung Perfusion Improves Lung Preservation.
[So] Source:Transplantation;101(12):2841-2849, 2017 12.
[Is] ISSN:1534-6080
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The role of the circulating leukocytes in lungs and their relationship with circulating proinflammatory cytokines during ischemia-reperfusion injury is not well understood. Using ex vivo lung perfusion (EVLP) to investigate the pathophysiology of isolated lungs, we aimed to identify a therapeutic target to optimize lung preservation leading to successful lung transplantation. METHODS: Rat heart-lung blocks were placed on EVLP for 4 hours with or without a leukocyte-depleting filter (LF). After EVLP, lung grafts were transplanted, and posttransplant outcomes were compared. RESULTS: Lung function was significantly better in lung grafts on EVLP with a LF than in lungs on EVLP without a LF. The interleukin (IL)-6 levels in the lung grafts and EVLP perfusate were also significantly lower after EVLP with a LF. Interestingly, IL-6 levels in the perfusate did not increase after the lungs were removed from the EVLP circuit, indicating that the cells trapped by the LF were not secreting IL-6. The trapped cells were analyzed with flow cytometry to detect apoptosis and pyroptosis; 26% were pyroptotic (Caspase-1-positive). After transplantation, there was better graft function and less inflammatory response if a LF was used or a caspase-1 inhibitor was administered during EVLP. CONCLUSIONS: Our data demonstrated that circulating leukocytes derived from donor lungs, and not circulating proinflammatory cytokines substantially impaired the quality of lung grafts through caspase-1-induced pyroptotic cell death during EVLP. Removing these cells with a LF and/or inhibiting pyroptosis of the cells can be a new therapeutic approach leading to long-term success after lung transplantation.
[Mh] Termos MeSH primário: Leucócitos/citologia
Transplante de Pulmão/métodos
Pulmão/patologia
Pulmão/fisiologia
Preservação de Órgãos/métodos
Piroptose
[Mh] Termos MeSH secundário: Animais
Ponte Cardiopulmonar
Caspase 1/metabolismo
Citocinas/metabolismo
Seres Humanos
Inflamação
Interleucina-6/metabolismo
Leucócitos/metabolismo
Masculino
Microcirculação
Perfusão
Ratos
Ratos Endogâmicos Lew
Testes de Função Respiratória
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cytokines); 0 (Interleukin-6); EC 3.4.22.36 (Caspase 1)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1097/TP.0000000000001798


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[PMID]:28464745
[Au] Autor:Bakke KM; Hole KH; Dueland S; Grøholt KK; Flatmark K; Ree AH; Seierstad T; Redalen KR
[Ad] Endereço:a Department of Oncology , Akershus University Hospital , Lørenskog , Norway.
[Ti] Título:Diffusion-weighted magnetic resonance imaging of rectal cancer: tumour volume and perfusion fraction predict chemoradiotherapy response and survival.
[So] Source:Acta Oncol;56(6):813-818, 2017 Jun.
[Is] ISSN:1651-226X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In locally advanced rectal cancer (LARC), responses to preoperative treatment are highly heterogeneous and more accurate diagnostics are likely to enable more individualised treatment approaches with improved responses. We investigated the potential of diffusion-weighted magnetic resonance imaging (DW MRI), with quantification of the apparent diffusion coefficient (ADC) and perfusion fraction (F), as well as volumetry from T2-weighted (T2W) MRI, for prediction of therapeutic outcome. MATERIAL AND METHODS: In 27 LARC patients receiving neoadjuvant chemotherapy (NACT) before chemoradiotherapy (CRT), T2W- and DW MRI were obtained before and after NACT. Tumour volumes were delineated in T2W MRI and ADCs and Fs were estimated from DW MRI using a simplified approach to the intravoxel incoherent motion (IVIM) model. Mean tumour values and histogram analysis of whole-tumour heterogeneity were correlated with histopathologic tumour regression grade (TRG) and 5-year progression-free survival (PFS). RESULTS: At baseline, high tumour F predicted good tumour response (TRG1-2) (AUC = 0.79, p = 0.01), with a sensitivity of 69% and a specificity of 100%. The combination of F and tumour volume (F /V ) gave the highest prediction of poor tumour response (AUC = 0.93, p < 0.001) with a sensitivity of 88% and a specificity of 91%, and also predicted PFS (p < 0.01). Baseline tumour ADC was not significantly related to therapeutic outcome, whereas a positive change in ADC from baseline to after NACT, ΔADC, significantly predicted good tumour response (AUC = 0.83, p < 0.01, 83% sensitivity, 73% specificity), but not PFS. CONCLUSIONS: The MRI parameter F/V at baseline was a remarkably strong predictor of both histopathologic tumour response and 5-year PFS in patients with LARC.
[Mh] Termos MeSH primário: Quimiorradioterapia Adjuvante/mortalidade
Imagem de Difusão por Ressonância Magnética/métodos
Terapia Neoadjuvante/mortalidade
Neoplasias Retais/patologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Processamento de Imagem Assistida por Computador/métodos
Gradação de Tumores
Perfusão
Estudos Prospectivos
Curva ROC
Neoplasias Retais/mortalidade
Neoplasias Retais/terapia
Taxa de Sobrevida
Resultado do Tratamento
Carga Tumoral
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1080/0284186X.2017.1287951


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[PMID]:28741663
[Au] Autor:Stehouwer MC; de Vroege R; Hoohenkerk GJF; Hofman FN; Kelder JC; Buchner B; de Mol BA; Bruins P
[Ad] Endereço:Department of Extracorporeal Circulation, St Antonius Hospital, Nieuwegein, The Netherlands.
[Ti] Título:Carbon Dioxide Flush of an Integrated Minimized Perfusion Circuit Prior to Priming Prevents Spontaneous Air Release Into the Arterial Line During Clinical Use.
[So] Source:Artif Organs;41(11):997-1003, 2017 Nov.
[Is] ISSN:1525-1594
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Recently, an oxygenator with an integrated centrifugal blood pump (IP) was designed to minimize priming volume and to reduce blood foreign surface contact even further. The use of this oxygenator with or without integrated arterial filter was compared with a conventional oxygenator and nonintegrated centrifugal pump. To compare the air removal characteristics 60 patients undergoing coronary artery bypass grafting were alternately assigned into one of three groups to be perfused with a minimized extracorporeal circuit either with the conventional oxygenator, the oxygenator with IP, or the oxygenator with IP plus integrated arterial filter (IAF). Air entering and leaving the three devices was measured accurately with a bubble counter during cardiopulmonary bypass. No significant differences between all groups were detected, considering air entering the devices. Our major finding was that in both integrated devices groups incidental spontaneous release of air into the arterial line in approximately 40% of the patients was observed. Here, detectable bolus air (>500 µm) was shown in the arterial line, whereas in the minimal extracorporeal circulation circuit (MECC) group this phenomenon was not present. We decided to conduct an amendment of the initial design with METC-approval. Ten patients were assigned to be perfused with an oxygenator with IP and IAF. Importantly, the integrated perfusion systems used in these patients were flushed with carbon dioxide (CO ) prior to priming of the systems. In the group with CO flush no spontaneous air release was observed in all cases and this was significantly different from the initial study with the group with the integrated device and IAF. This suggests that air spilling may be caused by residual air in the integrated device. In conclusion, integration of a blood pump may cause spontaneous release of large air bubbles (>500 µm) into the arterial line, despite the presence of an integrated arterial filter. CO flushing of an integrated cardiopulmonary bypass system prior to priming may prevent spontaneous air release and is strongly recommended to secure patient safety.
[Mh] Termos MeSH primário: Dióxido de Carbono
Ponte Cardiopulmonar/instrumentação
Cateteres
Ponte de Artéria Coronária
Embolia Aérea/prevenção & controle
Oxigenação por Membrana Extracorpórea/instrumentação
Coração Auxiliar
Oxigenadores
Perfusão/instrumentação
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Ponte Cardiopulmonar/efeitos adversos
Ponte de Artéria Coronária/efeitos adversos
Embolia Aérea/diagnóstico
Embolia Aérea/etiologia
Oxigenação por Membrana Extracorpórea/efeitos adversos
Feminino
Seres Humanos
Masculino
Meia-Idade
Perfusão/efeitos adversos
Desenho de Prótese
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
142M471B3J (Carbon Dioxide)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1111/aor.12909


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[PMID]:29267404
[Au] Autor:Kierulf-Lassen C; Nielsen PM; Qi H; Damgaard M; Laustsen C; Pedersen M; Krag S; Birn H; Nørregaard R; Jespersen B
[Ad] Endereço:Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark.
[Ti] Título:Unilateral nephrectomy diminishes ischemic acute kidney injury through enhanced perfusion and reduced pro-inflammatory and pro-fibrotic responses.
[So] Source:PLoS One;12(12):e0190009, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:While unilateral nephrectomy (UNx) is suggested to protect against ischemia-reperfusion injury (IRI) in the remaining kidney, the mechanisms underlying this protection remain to be elucidated. In this study, functional MRI was employed in a renal IRI rat model to reveal global and regional changes in renal filtration, perfusion, oxygenation and sodium handling, and microarray and pathway analyses were conducted to identify protective molecular mechanisms. Wistar rats were randomized to either UNx or sham UNx immediately prior to 37 minutes of unilateral renal artery clamping or sham operation under sevoflurane anesthesia. MRI was performed 24 hours after reperfusion. Blood and renal tissue were harvested. RNA was isolated for microarray analysis and QPCR validation of gene expression results. The perfusion (T1 value) was significantly enhanced in the medulla of the post-ischemic kidney following UNx. UNx decreased the expression of fibrogenic genes, i.a. Col1a1, Fn1 and Tgfb1 in the post-ischemic kidney. This was associated with a marked decrease in markers of activated myofibroblasts (Acta2/α-Sma and Cdh11) and macrophages (Ccr2). This was most likely facilitated by down-regulation of Pdgfra, thus inhibiting pericyte-myofibroblast differentiation, chemokine production (Ccl2/Mcp1) and macrophage infiltration. UNx reduced ischemic histopathologic injury. UNx may exert renoprotective effects against IRI through increased perfusion in the renal medulla and alleviation of the acute pro-inflammatory and pro-fibrotic responses possibly through decreased myofibroblast activation. The identified pathways involved may serve as potential therapeutic targets and should be taken into account in experimental models of IRI.
[Mh] Termos MeSH primário: Lesão Renal Aguda/terapia
Inflamação/prevenção & controle
Nefrectomia/métodos
Traumatismo por Reperfusão/terapia
[Mh] Termos MeSH secundário: Lesão Renal Aguda/cirurgia
Animais
Fibrose
Regulação da Expressão Gênica
Imagem por Ressonância Magnética
Masculino
Perfusão
Ratos
Ratos Wistar
Reação em Cadeia da Polimerase em Tempo Real
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; VALIDATION STUDIES
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190009


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[PMID]:29257015
[Au] Autor:Lazaro LE; Nawabi DH; Klinger CE; Sculco PK; van der List JP; Dyke JP; Helfet DL; Kelly BT; Lorich DG
[Ad] Endereço:Sports Medicine Service (D.H.N. and B.T.K.), Orthopaedic Trauma Service (C.E.K, D.L.H., and D.G.L.), Adult Reconstruction and Joint Replacement Service (P.K.S.), and Center for Hip Preservation (D.H.N., D.L.H., B.T.K., and D.G.L.), Hospital for Special Surgery and New York Presbyterian Hospital (L.E
[Ti] Título:Quantitative Assessment of Femoral Head Perfusion Following Arthroscopic Femoral Osteochondroplasty: A Cadaveric Study.
[So] Source:J Bone Joint Surg Am;99(24):2094-2102, 2017 Dec 20.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Disruption of the arterial supply to the femoral head, and subsequent development of femoral head osteonecrosis, is of serious concern with intracapsular hip procedures. However, the effect of arthroscopic femoral osteochondroplasty on femoral head perfusion is unknown. We aimed to quantify the effects of both standard and posterosuperior extension of arthroscopic femoral osteochondroplasty on femoral head vascularity. We hypothesized that extension of the superior resection zone posteriorly would negatively affect femoral head perfusion. METHODS: In 12 cadaveric pelvic specimens, we cannulated the medial femoral circumflex artery (MFCA). One hip per pelvis was randomly selected to be in 1 of 2 experimental groups based on the superior extent of the osteochondroplasty: standard resection (resection anterior to the 12 o'clock [0° of 360°] position) or extended resection (resection extended posterior to the 12 o'clock position). Computed tomography (CT) scans were obtained prior to and following arthroscopic resection to delineate the resection margins. Gadolinium enhancement on magnetic resonance imaging (MRI) was quantified in the femoral head by volumetric analysis using custom software. A polyurethane compound was injected and gross dissection of the vasculature was performed. RESULTS: Extension of the osteochondroplasty posteriorly (the extended-resection group), to a mean of 41.3° (range, 34° to 47°) posterior to the 12 o'clock position, decreased femoral head perfusion by a mean of 28% (range, 18% to 38%). The standard-resection group demonstrated a mean decrease in femoral head perfusion of 7% (range, 4% to 11%). Correlation analysis demonstrated a significant negative correlation (correlation coefficient, -0.877; p < 0.001; R = 0.747). For every 1° that the superior resection margin extended posteriorly, a corresponding 0.88% decrease in femoral head perfusion was found. CONCLUSIONS: Femoral head perfusion is almost fully maintained with arthroscopic osteochondroplasty when the superior resection margin is anterior to the 12 o'clock position. Perfusion is also well maintained if the superior resection margin is extended no more than 10° posterior to 12 o'clock. Further posterior extension correlated with greater decreases in femoral head perfusion. CLINICAL RELEVANCE: Our study provides previously unreported quantitative MRI data on femoral head perfusion following arthroscopic femoral osteochondroplasty for the treatment of cam-type femoroacetabular impingement.
[Mh] Termos MeSH primário: Artroscopia/métodos
Cabeça do Fêmur/irrigação sanguínea
Cabeça do Fêmur/cirurgia
Articulação do Quadril/diagnóstico por imagem
Articulação do Quadril/cirurgia
[Mh] Termos MeSH secundário: Idoso
Cadáver
Estudos de Avaliação como Assunto
Feminino
Seres Humanos
Imagem por Ressonância Magnética/métodos
Masculino
Meia-Idade
Perfusão/métodos
Fluxo Sanguíneo Regional/fisiologia
Estatísticas não Paramétricas
Tomografia Computadorizada por Raios X/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.01556



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