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  1 / 14209 MEDLINE  
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[PMID]:29176758
[Au] Autor:Bonsante F; Gouyon JB; Robillard PY; Gouyon B; Iacobelli S
[Ad] Endereço:Réanimation Néonatale et Pédiatrique, Néonatologie, Centre Hospitalier Universitaire de la Réunion, Site Sud Saint Pierre, France.
[Ti] Título:Early optimal parenteral nutrition and metabolic acidosis in very preterm infants.
[So] Source:PLoS One;12(11):e0186936, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: It is currently recognized that an optimized nutritional approach, consisting of an early and substantial supply of protein and energy by parenteral route, may be beneficial for very low birth weight infants and recent guidelines endorse this strategy. However, the impact of the enhanced parenteral nutrition (PN) on acid-basic balance has never been investigated. The aim of the present study is to assess the effect of nutrient intake on acid-base homeostasis in a large population of preterm infants on PN. METHODS: This observational study described the acid-base profile of very preterm infants (≤29 week's gestation) receiving PN during the first week of life. For this purpose three different cohorts of infants who received increasing (group 1 to group 3) nutritional intakes were considered. Nutrition data were recorded daily and correlated to acid-base data (pH, base excess, and lactate). The outcome measure to assess metabolic acidosis was the base excess (BE). RESULTS: 161 infants were included. 1127 daily nutritional records and 795 blood gas data were analyzed. The three groups were different with regard to nutritional intravenous intakes. Group 3 in particular had a higher mean intake of both amino acids (3.3 ± 0.8 g/kg/d) and lipids (2.8 ± 1.4 g/kg/d) during the first week of life. Metabolic acidosis was more severe in the group with the highest parenteral intake of amino acids and lipids: mean BE = -8.7 ± 3.4 (group 3); -6.4 ± 3.4 (group 2); -5.1 ± 3.0 (group 1)]. At the multivariate analysis the significant risk factors for metabolic acidosis were: gestational age, initial base excess, amino acid and lipid intravenous intakes. DISCUSSION: Acid-base homeostasis was influenced by the nutritional intake. Earlier and higher intravenous amino acid and lipid intakes particularly increased the risk of metabolic acidosis. The nutritional tolerance was different depending on gestational age, and the smaller infants (24-26 week's gestation) displayed greater acidotic disequilibrium and a higher need of bicarbonate.
[Mh] Termos MeSH primário: Acidose/terapia
Recém-Nascido Prematuro/fisiologia
Nutrição Parenteral
[Mh] Termos MeSH secundário: Equilíbrio Ácido-Base
Aminoácidos/metabolismo
Idade Gestacional
Seres Humanos
Concentração de Íons de Hidrogênio
Recém-Nascido
Lipídeos
Análise Multivariada
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Amino Acids); 0 (Lipids)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186936


  2 / 14209 MEDLINE  
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[PMID]:29073182
[Au] Autor:Barba-Vidal E; Buttow Roll VF; Garcia Manzanilla E; Torrente C; Moreno Muñoz JA; Pérez JF; Martín-Orúe SM
[Ad] Endereço:Animal Nutrition and Welfare Service, Departament de Ciència Animal i dels Aliments, Universitat Autònoma de Barcelona; Bellaterra, Spain.
[Ti] Título:Blood parameters as biomarkers in a Salmonella spp. disease model of weaning piglets.
[So] Source:PLoS One;12(10):e0186781, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The weaning pig is used as an experimental model to assess the impact of diet on intestinal health. Blood parameters (BP) are considered a useful tool in humans, but there is very scarce information of such indicators in the weaning pig. The objective of the present study is to evaluate the use of different BP as indicators in an experimental model of salmonellosis. METHODOLOGY: Seventy-two 28-day-old piglets were divided into four groups in a 2x2 factorial arrangement, with animals receiving or not a probiotic combination based on B. infantis IM1® and B. lactis BPL6 (109 colony forming units (cfu)/d) and orally challenged or not a week later with Salmonella Typhimurium (5x108 cfu). Blood samples of one animal per pen (N = 24) were taken four days post-inoculation for the evaluation of different BP using an I-stat® System and of plasmatic concentrations of zinc, iron and copper. PRINCIPAL FINDINGS: Results reported marginal deficiencies of zinc in piglets at weaning. Moreover, plasmatic zinc, copper and iron presented good correlations with weight gain (r 0.57, r -0.67, r 0.54 respectively; P < 0.01). Blood electrolytes (Na+, Cl- and K+) decreased (P < 0.01) only when the performance of the animals was seriously compromised and clinical symptoms were more apparent. Acid-base balance parameters such as HCO3-, TCO2 and BEecf significantly correlated with weight gain, but only in the challenged animals (r -0.54, r -0.55, and r -0.51, respectively; P < 0.05), suggesting metabolic acidosis depending on Salmonella infection. Glucose was affected by the challenge (P = 0.040), while Htc and Hgb increased with the challenge and decreased with the probiotic (P < 0.05). Furthermore, correlations of Glu, Htc and Hgb with weight gain were observed (P < 0.05). Overall, BP could be regarded as simple, useful indexes to assess performance and health of weaning piglets.
[Mh] Termos MeSH primário: Infecções por Salmonella/sangue
Salmonella
Doenças dos Suínos/sangue
[Mh] Termos MeSH secundário: Equilíbrio Ácido-Base
Animais
Biomarcadores/sangue
Glicemia/metabolismo
Modelos Animais de Doenças
Metais/sangue
Suínos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Blood Glucose); 0 (Metals)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171027
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186781


  3 / 14209 MEDLINE  
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[PMID]:28834879
[Au] Autor:Gladki M; Skladzien T; Zurek R; Broniatowska E; Wójcik E; Skalski JH
[Ad] Endereço:aDepartment of Pediatric Cardiac Surgery, University Children's Hospital, Jagiellonian University bAnaesthesiology and Intensive Care Clinic, University Hospital cDepartment of Bioinformatic and Telemedicine, Jagiellonian University, Krakow, Poland.
[Ti] Título:Effect of acid-base balance on postoperative course in children with hypoplastic left heart syndrome after the modified Norwood procedure.
[So] Source:Medicine (Baltimore);96(34):e7739, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Hypoplastic left heart syndrome (HLHS) is a congenital heart defect that requires 3-stage cardiac surgical treatment and multidirectional specialist care. The condition of newborns in the first postoperative days following the modified Norwood procedure is characterized by considerable hemodynamic instability that may result in a sudden cardiac arrest. It is believed that the most important cause of hemodynamic instability is the fluctuations in redistribution between pulmonary and systemic blood flow.The paper analyzes the postoperative course in 40 neonates with HLHS following the modified Norwood procedure performed under deep hypothermic cardiopulmonary bypass hospitalized in Cardiac Surgical Intensive Care Unit (CSICU) in the years 2014-2015. For all hospitalized children, the arterial blood acid-base balance (ABB) parameters (pH, pO2, pCO2, HCO3, base excess (BE), and lactic acid) were measured 2 times a day during the first 5 postoperative days. The main goal of the studies is to analysis of ABB parameters and their influence on the clinical state of newborns with HLHS. Several descriptors were concerned to describe the neonates clinical state: the date of the surgery (the day of life when the child was operated on), the duration (number of days) of mechanical ventilation employment, the time of hospitalization in intensive care unit, and the total duration of treatment in CSICU.The statistical analysis of the particular ABB parameters revealed a significant dependence (P < .001) between the values of pH, pO2, pCO2, HCO3, BE, lactic acid, and all concerned descriptors of the newborn clinical state.The article shows that monitoring the ABB parameters, proper interpretation of the results, and appropriate modification of pharmacotherapy and respiratory treatment are crucial for therapeutic results and survival rates in neonates with HLHS after the modified Norwood procedure.
[Mh] Termos MeSH primário: Equilíbrio Ácido-Base/fisiologia
Síndrome do Coração Esquerdo Hipoplásico/cirurgia
Procedimentos de Norwood/métodos
[Mh] Termos MeSH secundário: Gasometria
Feminino
Seres Humanos
Síndrome do Coração Esquerdo Hipoplásico/mortalidade
Recém-Nascido
Ácido Láctico/sangue
Masculino
Procedimentos de Norwood/mortalidade
Período Pós-Operatório
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
33X04XA5AT (Lactic Acid)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007739


  4 / 14209 MEDLINE  
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[PMID]:28695610
[Au] Autor:Li Y; Matzka L; Maranda L; Weber D
[Ad] Endereço:Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, U.S.A.
[Ti] Título:Anion gap can differentiate between psychogenic and epileptic seizures in the emergency setting.
[So] Source:Epilepsia;58(9):e132-e135, 2017 Sep.
[Is] ISSN:1528-1167
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Differentiation between psychogenic nonepileptic seizures (PNES) and generalized convulsive epileptic seizures (ES) is important for appropriate triaging in the emergency department (ED). This can be difficult in the ED, as the event is often not witnessed by a medical professional. In the current study, we investigated whether anion gap (AG), bicarbonate, and the Denver Seizure Score (DSS) could differentiate between PNES and ES. Of a total of 1,354 subjects reviewed from a tertiary care medical center, 27 PNES and 27 ES patients were identified based on clinical description and subsequent electroencephalogram. Multivariate logistic regression analysis and receiver operating characteristic curves were used to determine whether there was an association between seizure type and AG, bicarbonate, or DSS (24-bicarbonate + 2 × [AG-12]) when samples were drawn within 24 h of the concerning event. The result showed that sensitivity and negative predictive value dropped markedly for all measures if samples were drawn >2 h after the event; the sensitivity was similar for AG and DSS and higher than for bicarbonate. We propose that AG > 10 (sensitivity of 81.8%, specificity of 100%) in the first 2 h after the event could be used as a potential tool in the ED to help differentiate between PNES and ES.
[Mh] Termos MeSH primário: Epilepsia/etiologia
Convulsões/etiologia
[Mh] Termos MeSH secundário: Equilíbrio Ácido-Base
Adulto
Bicarbonatos/sangue
Eletroencefalografia
Serviço Hospitalar de Emergência
Epilepsia/sangue
Epilepsia/diagnóstico
Seres Humanos
Curva ROC
Estudos Retrospectivos
Convulsões/sangue
Convulsões/diagnóstico
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bicarbonates)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170712
[St] Status:MEDLINE
[do] DOI:10.1111/epi.13840


  5 / 14209 MEDLINE  
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[PMID]:28677491
[Au] Autor:Ltaief Z; Liaudet L; Manzon C
[Ad] Endereço:1 Service de Médecine Intensive Adulte et Centre des Brûlés, Centre Hospitalier Universitaire Vaudois et Faculté de Biologie et Médecine, Lausanne.
[Ti] Título:Décompensation pulmonaire ou cardiaque chez l'adulte, à quand les soins intensifs?.
[So] Source:Praxis (Bern 1994);106(14):767-773, 2017 Jul.
[Is] ISSN:1661-8157
[Cp] País de publicação:Switzerland
[La] Idioma:fre
[Mh] Termos MeSH primário: Insuficiência Cardíaca/terapia
Unidades de Terapia Intensiva
Insuficiência Respiratória/terapia
[Mh] Termos MeSH secundário: Equilíbrio Ácido-Base/fisiologia
Adulto
Dióxido de Carbono/sangue
Intervenção Médica Precoce
Insuficiência Cardíaca/etiologia
Insuficiência Cardíaca/fisiopatologia
Seres Humanos
Ventilação não Invasiva
Oxigênio/sangue
Oxigenoterapia
Prognóstico
Insuficiência Respiratória/etiologia
Insuficiência Respiratória/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
142M471B3J (Carbon Dioxide); S88TT14065 (Oxygen)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170706
[St] Status:MEDLINE
[do] DOI:10.1024/1661-8157/a002726


  6 / 14209 MEDLINE  
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[PMID]:28645705
[Au] Autor:Khairallah P; Isakova T; Asplin J; Hamm L; Dobre M; Rahman M; Sharma K; Leonard M; Miller E; Jaar B; Brecklin C; Yang W; Wang X; Feldman H; Wolf M; Scialla JJ; Chronic Renal Insufficiency Cohort (CRIC) Study Investigators
[Ad] Endereço:Department of Medicine, Duke University School of Medicine, Durham, NC.
[Ti] Título:Acid Load and Phosphorus Homeostasis in CKD.
[So] Source:Am J Kidney Dis;70(4):541-550, 2017 Oct.
[Is] ISSN:1523-6838
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The kidneys maintain acid-base homeostasis through excretion of acid as either ammonium or as titratable acids that primarily use phosphate as a buffer. In chronic kidney disease (CKD), ammoniagenesis is impaired, promoting metabolic acidosis. Metabolic acidosis stimulates phosphaturic hormones, parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF-23) in vitro, possibly to increase urine titratable acid buffers, but this has not been confirmed in humans. We hypothesized that higher acid load and acidosis would associate with altered phosphorus homeostasis, including higher urinary phosphorus excretion and serum PTH and FGF-23. STUDY DESIGN: Cross-sectional. SETTING & PARTICIPANTS: 980 participants with CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study. PREDICTORS: Net acid excretion as measured in 24-hour urine, potential renal acid load (PRAL) estimated from food frequency questionnaire responses, and serum bicarbonate concentration < 22 mEq/L. OUTCOME & MEASUREMENTS: 24-hour urine phosphorus and calcium excretion and serum phosphorus, FGF-23, and PTH concentrations. RESULTS: Using linear and log-linear regression adjusted for demographics, kidney function, comorbid conditions, body mass index, diuretic use, and 24-hour urine creatinine excretion, we found that 24-hour urine phosphorus excretion was higher at higher net acid excretion, higher PRAL, and lower serum bicarbonate concentration (each P<0.05). Serum phosphorus concentration was also higher with higher net acid excretion and lower serum bicarbonate concentration (each P=0.001). Only higher net acid excretion associated with higher 24-hour urine calcium excretion (P<0.001). Neither net acid excretion nor PRAL was associated with FGF-23 or PTH concentrations. PTH, but not FGF-23, concentration (P=0.2) was 26% (95% CI, 13%-40%) higher in participants with a serum bicarbonate concentration <22 versus ≥22 mEq/L (P<0.001). Primary results were similar if stratified by estimated glomerular filtration rate categories or adjusted for iothalamate glomerular filtration rate (n=359), total energy intake, dietary phosphorus, or urine urea nitrogen excretion, when available. LIMITATIONS: Possible residual confounding by kidney function or nutrition; urine phosphorus excretion was included in calculation of the titratable acid component of net acid excretion. CONCLUSIONS: In CKD, higher acid load and acidosis associate independently with increased circulating phosphorus concentration and augmented phosphaturia, but not consistently with FGF-23 or PTH concentrations. This may be an adaptation that increases titratable acid excretion and thus helps maintain acid-base homeostasis in CKD. Understanding whether administration of base can lower phosphorus concentrations requires testing in interventional trials.
[Mh] Termos MeSH primário: Equilíbrio Ácido-Base
Bicarbonatos/sangue
Cálcio/urina
Fatores de Crescimento de Fibroblastos/sangue
Homeostase
Hormônio Paratireóideo/sangue
Fósforo/sangue
Fósforo/urina
Insuficiência Renal Crônica/sangue
Insuficiência Renal Crônica/urina
[Mh] Termos MeSH secundário: Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Insuficiência Renal Crônica/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bicarbonates); 0 (Parathyroid Hormone); 0 (fibroblast growth factor 23); 27YLU75U4W (Phosphorus); 62031-54-3 (Fibroblast Growth Factors); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170625
[St] Status:MEDLINE


  7 / 14209 MEDLINE  
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[PMID]:28642298
[Au] Autor:Golriz M; Abbasi S; Fathi P; Majlesara A; Brenner T; Mehrabi A
[Ad] Endereço:Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany; and Mohammad.golriz@med.uni-heidelberg.de.
[Ti] Título:Does acid-base equilibrium correlate with remnant liver volume during stepwise liver resection?
[So] Source:Am J Physiol Gastrointest Liver Physiol;313(4):G313-G319, 2017 Oct 01.
[Is] ISSN:1522-1547
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Small for size and flow syndrome (SFSF) is one of the most challenging complications following extended hepatectomy (EH). After EH, hepatic artery flow decreases and portal vein flow increases per 100 g of remnant liver volume (RLV). This causes hypoxia followed by metabolic acidosis. A correlation between acidosis and posthepatectomy liver failure has been postulated but not studied systematically in a large animal model or clinical setting. In our study, we performed stepwise liver resections on nine pigs to defined SFSF limits as follows: step 1: segment II/III resection, step 2: segment IV resection, step 3: segment V/VIII resection (RLV: 75, 50, and 25%, respectively). Blood gas values were measured before and after each step using four catheters inserted into the carotid artery, internal jugular vein, hepatic artery, and portal vein. The pH, [Formula: see text], and base excess (BE) decreased, but [Formula: see text] values increased after 75% resection in the portal and jugular veins. EH correlated with reduced BE in the hepatic artery. Pco values increased after 75% resection in the jugular vein. In contrast, arterial Po increased after every resection, whereas the venous Po decreased slightly. There were differences in venous [Formula: see text], BE in the hepatic artery, and Pco in the jugular vein after 75% liver resection. Because 75% resection is the limit for SFSF, these noninvasive blood evaluations may be used to predict SFSF. Further studies with long-term follow-up are required to validate this correlation. This is the first study to evaluate acid-base parameters in major central and hepatic vessels during stepwise liver resection. The pH, [Formula: see text], and base excess (BE) decreased, but [Formula: see text] values increased after 75% resection in the portal and jugular veins. Extended hepatectomy correlated with reduced BE in the hepatic artery. Because 75% resection is the limit for small for size and flow syndrome (SFSF), postresection blood gas evaluations may be used to predict SFSF.
[Mh] Termos MeSH primário: Equilíbrio Ácido-Base
Hepatectomia/efeitos adversos
Hepatopatias/etiologia
Hepatopatias/fisiopatologia
Fígado/fisiopatologia
Fígado/cirurgia
[Mh] Termos MeSH secundário: Animais
Hepatectomia/métodos
Fígado/patologia
Circulação Hepática
Hepatopatias/patologia
Tamanho do Órgão/fisiologia
Suínos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[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:170624
[St] Status:MEDLINE
[do] DOI:10.1152/ajpgi.00110.2017


  8 / 14209 MEDLINE  
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[PMID]:28598894
[Au] Autor:Lee AJ; Landau R; Mattingly JL; Meenan MM; Corradini B; Wang S; Goodman SR; Smiley RM
[Ad] Endereço:From the Division of Obstetric Anesthesia, Department of Anesthesia, Columbia University, New York, New York (A.J.L., R.L., B.C., S.R.G., R.M.S.); Department of Anesthesia, New York-Presbyterian/Columbia University Medical Center, New York, New York (J.L.M., M.M.M.); and Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York (S.W.).
[Ti] Título:Left Lateral Table Tilt for Elective Cesarean Delivery under Spinal Anesthesia Has No Effect on Neonatal Acid-Base Status: A Randomized Controlled Trial.
[So] Source:Anesthesiology;127(2):241-249, 2017 Aug.
[Is] ISSN:1528-1175
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Current recommendations for women undergoing cesarean delivery include 15° left tilt for uterine displacement to prevent aortocaval compression, although this degree of tilt is practically never achieved. We hypothesized that under contemporary clinical practice, including a crystalloid coload and phenylephrine infusion targeted at maintaining baseline systolic blood pressure, there would be no effect of maternal position on neonatal acid base status in women undergoing elective cesarean delivery with spinal anesthesia. METHODS: Healthy women undergoing elective cesarean delivery were randomized (nonblinded) to supine horizontal (supine, n = 50) or 15° left tilt of the surgical table (tilt, n = 50) after spinal anesthesia (hyperbaric bupivacaine 12 mg, fentanyl 15 µg, preservative-free morphine 150 µg). Lactated Ringer's 10 ml/kg and a phenylephrine infusion titrated to 100% baseline systolic blood pressure were initiated with intrathecal injection. The primary outcome was umbilical artery base excess. RESULTS: There were no differences in umbilical artery base excess or pH between groups. The mean umbilical artery base excess (± SD) was -0.5 mM (± 1.6) in the supine group (n = 50) versus -0.6 mM (± 1.5) in the tilt group (n = 47) (P = 0.64). During 15 min after spinal anesthesia, mean phenylephrine requirement was greater (P = 0.002), and mean cardiac output was lower (P = 0.014) in the supine group. CONCLUSIONS: Maternal supine position during elective cesarean delivery with spinal anesthesia in healthy term women does not impair neonatal acid-base status compared to 15° left tilt, when maternal systolic blood pressure is maintained with a coload and phenylephrine infusion. These findings may not be generalized to emergency situations or nonreassuring fetal status.
[Mh] Termos MeSH primário: Equilíbrio Ácido-Base/fisiologia
Anestesia Obstétrica
Raquianestesia
Cesárea
Procedimentos Cirúrgicos Eletivos
Posicionamento do Paciente/métodos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Recém-Nascido
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170610
[St] Status:MEDLINE
[do] DOI:10.1097/ALN.0000000000001737


  9 / 14209 MEDLINE  
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[PMID]:28531309
[Au] Autor:Unsal AB; Mattingly AS; Jones SE; Purdy JB; Reynolds JC; Kopp JB; Hazra R; Hadigan CM
[Ad] Endereço:Laboratory of Immunoregulation, National Institute of Allergy and Infectious Disease, Bethesda, Maryland 20892.
[Ti] Título:Effect of Antiretroviral Therapy on Bone and Renal Health in Young Adults Infected With HIV in Early Life.
[So] Source:J Clin Endocrinol Metab;102(8):2896-2904, 2017 Aug 01.
[Is] ISSN:1945-7197
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Context: HIV antiretroviral (ARV) therapy is associated with renal and bone toxicity, but little is known about the potential cumulative effects in adults exposed to ARVs from birth. Objective: To prospectively evaluate renal and bone health in young adults with lifelong HIV and extensive ARV exposure. Design: Cross-sectional comparison of bone mineral density (BMD) by dual-energy X-ray absorptiometry, bone turnover, and renal function in young adults infected with HIV in early life (n = 65) to matched healthy controls (n = 23) and longitudinal evaluation (mean follow-up = 4.4 years) within a subset of the HIV cohort (n = 33). Setting: Government outpatient research clinic. Results: Albumin/creatinine ratio, protein/creatinine ratio, anion gap, N-terminal telopeptides, and osteocalcin were significantly increased in persons with HIV compared with controls, whereas whole-body BMD and BMD z scores were lower. Within the HIV group, duration of tenofovir disoproxil fumarate (TDF) correlated with higher anion gap but did not correlate with bone parameters. Longer duration of didanosine and stavudine use correlated with lower BMD and BMD z scores. Longitudinal analyses revealed that BMD and bone metabolism significantly improved over time. No subject had an estimated glomerular filtration rate (eGFR) <60, but decline in eGFR correlated with increasing years of TDF exposure. Conclusions: Subclinical markers of renal dysfunction were increased in HIV-infected young adults and associated with TDF exposure, whereas lower bone density was associated with didanosine and stavudine exposure. The tendency for improvement in markers of bone health over time and the availability of less toxic ARV alternatives may herald improvements in renal and bone health for perinatally infected patients in adulthood.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/uso terapêutico
Densidade Óssea
Doenças Ósseas Metabólicas/diagnóstico por imagem
Remodelação Óssea
Infecções por HIV/tratamento farmacológico
Insuficiência Renal/urina
[Mh] Termos MeSH secundário: Absorciometria de Fóton
Equilíbrio Ácido-Base
Adulto
Idade de Início
Albuminúria
Terapia Antirretroviral de Alta Atividade
Doenças Ósseas Metabólicas/complicações
Doenças Ósseas Metabólicas/metabolismo
Estudos de Casos e Controles
Creatinina/urina
Estudos Transversais
Didanosina/uso terapêutico
Feminino
Taxa de Filtração Glomerular
Infecções por HIV/complicações
Infecções por HIV/metabolismo
Seres Humanos
Testes de Função Renal
Estudos Longitudinais
Masculino
Osteocalcina/metabolismo
Estudos Prospectivos
Proteinúria
Insuficiência Renal/complicações
Fatores de Risco
Estavudina/uso terapêutico
Tenofovir/uso terapêutico
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents); 104982-03-8 (Osteocalcin); 99YXE507IL (Tenofovir); AYI8EX34EU (Creatinine); BO9LE4QFZF (Stavudine); K3GDH6OH08 (Didanosine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170523
[St] Status:MEDLINE
[do] DOI:10.1210/jc.2017-00197


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[PMID]:28521710
[Au] Autor:Makowska J
[Ad] Endereço:Faculty of Chemistry, University of Gdansk, Wita Stwosza 63, 80-308 Gdansk. Poland.
[Ti] Título:Physicochemical and Structural Studies on Shaping of ß-hairpin in Proteins as a First Stage of Amyloid Formation.
[So] Source:Curr Protein Pept Sci;18(12):1244-1253, 2017.
[Is] ISSN:1875-5550
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:The aggregation of proteins or their digested fragments through ß-sheet structures has a great significance because it leads to neurodegenerative diseases, which are a problem of the aging societies of the developed countries. Short peptides are typically used as models to study the formation of specific structures. However, while the formation of α-helical structure was investigated thoroughly, until recently, there have been much fewer studies on the formation of ß-structure. In this review, recent experimental and theoretical studies of ß-hairpin-forming peptides, both model alaninebased systems, and those based on the fragments of real proteins, are summarized with regard to the role of hydrophobic, local, and Coulombic interactions. It is demonstrated that the presence of charged residues can induce a bent structure not only owing to the formation of salt bridges if oppositely- charged residues present at the ends of a sequence but also through shielding the hydrophobic interior by like-charged residues at the end of the sequence.
[Mh] Termos MeSH primário: Aminoácidos/química
Amiloide/química
Proteínas Amiloidogênicas/química
Proteínas de Bactérias/química
[Mh] Termos MeSH secundário: Equilíbrio Ácido-Base
Sequência de Aminoácidos
Amiloide/síntese química
Interações Hidrofóbicas e Hidrofílicas
Simulação de Dinâmica Molecular
Conformação Proteica em alfa-Hélice
Conformação Proteica em Folha beta
Dobramento de Proteína
Eletricidade Estática
Termodinâmica
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Amino Acids); 0 (Amyloid); 0 (Amyloidogenic Proteins); 0 (Bacterial Proteins); 0 (IgG Fc-binding protein, Streptococcus)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170520
[St] Status:MEDLINE
[do] DOI:10.2174/1389203718666170516111601



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