Base de dados : MEDLINE
Pesquisa : G07.313 [Categoria DeCS]
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[PMID]:28935759
[Au] Autor:Karlsen TV; Reikvam T; Tofteberg A; Nikpey E; Skogstrand T; Wagner M; Tenstad O; Wiig H
[Ad] Endereço:From the Department of Biomedicine, University of Bergen, Norway (T.V.K., T.R., A.T., E.N., T.S., M.W., O.T., H.W.); and Departments of Medicine (E.N.) and Pathology (M.W.), Haukeland University Hospital, Bergen, Norway. tine.karlsen@uib.no helge.wiig@uib.no.
[Ti] Título:Lymphangiogenesis Facilitates Initial Lymph Formation and Enhances the Dendritic Cell Mobilizing Chemokine CCL21 Without Affecting Migration.
[So] Source:Arterioscler Thromb Vasc Biol;37(11):2128-2135, 2017 Nov.
[Is] ISSN:1524-4636
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Lymphatic vessels play an important role in body fluid, as well as immune system homeostasis. Although the role of malfunctioning or missing lymphatics has been studied extensively, less is known on the functional consequences of a chronically expanded lymphatic network or lymphangiogenesis. APPROACH AND RESULTS: To this end, we used K14-VEGF-C (keratin-14 vascular endothelial growth factor-C) transgenic mice overexpressing the vascular endothelial growth factor C in skin and investigated the responses to inflammatory and fluid volume challenges. We also recorded interstitial fluid pressure, a major determinant of lymph flow. Transgenic mice had a strongly enhanced lymph vessel area in skin. Acute inflammation induced by lipopolysaccharide and chronic inflammation by delayed-type hypersensitivity both resulted in increased interstitial fluid pressure and reduced lymph flow, both to the same extent in wild-type and transgenic mice. Hyperplastic lymphatic vessels, however, demonstrated enhanced transport capacity after local fluid overload not induced by inflammation. In this situation, interstitial fluid pressure was increased to a similar extent in the 2 strains, thus, suggesting that the enhanced lymph vessel area facilitated initial lymph formation. The increased lymph vessel area resulted in an enhanced production of the chemoattractant CCL21 that, however, did not result in augmented dendritic cell migration after induction of local skin inflammation by fluorescein isothiocyanate. CONCLUSIONS: An expanded lymphatic network is capable of enhanced chemoattractant production, and lymphangiogenesis will facilitate initial lymph formation favoring increased clearance of fluid in situations of augmented fluid filtration.
[Mh] Termos MeSH primário: Quimiocina CCL21/metabolismo
Quimiotaxia
Células Dendríticas/metabolismo
Dermatite Alérgica de Contato/metabolismo
Linfa/metabolismo
Linfangiogênese
Vasos Linfáticos/metabolismo
Linfedema/metabolismo
[Mh] Termos MeSH secundário: Animais
Dermatite Alérgica de Contato/genética
Dermatite Alérgica de Contato/patologia
Dermatite Alérgica de Contato/fisiopatologia
Modelos Animais de Doenças
Líquido Extracelular/metabolismo
Feminino
Deslocamentos de Líquidos Corporais
Fluoresceína-5-Isotiocianato
Genótipo
Queratina-14/genética
Lipopolissacarídeos
Vasos Linfáticos/patologia
Vasos Linfáticos/fisiopatologia
Linfedema/genética
Linfedema/patologia
Linfedema/fisiopatologia
Masculino
Camundongos Endogâmicos C3H
Camundongos Transgênicos
Oxazolona
Fenótipo
Pressão
Regiões Promotoras Genéticas
Transdução de Sinais
Fatores de Tempo
Regulação para Cima
Fator C de Crescimento do Endotélio Vascular/genética
Fator C de Crescimento do Endotélio Vascular/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Chemokine CCL21); 0 (Keratin-14); 0 (Lipopolysaccharides); 0 (Vascular Endothelial Growth Factor C); 15646-46-5 (Oxazolone); I223NX31W9 (Fluorescein-5-isothiocyanate)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170923
[St] Status:MEDLINE
[do] DOI:10.1161/ATVBAHA.117.309883


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[PMID]:28818140
[Au] Autor:Kurazumi T; Ogawa Y; Yanagida R; Morisaki H; Iwasaki KI
[Ti] Título:Dynamic Cerebral Autoregulation During the Combination of Mild Hypercapnia and Cephalad Fluid Shift.
[So] Source:Aerosp Med Hum Perform;88(9):819-826, 2017 Sep 01.
[Is] ISSN:2375-6314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Mild hypercapnia combined with a cephalad fluid shift [e.g., that occurring during spaceflight or laparoscopic surgery with head-down tilt (HDT)] might affect cerebral autoregulation. However, no reports have described the effects of the combination on dynamic cerebral autoregulation. Therefore, we tested the hypothesis that the combination of mild hypercapnia and a cephalad fluid shift would attenuate dynamic cerebral autoregulation. METHODS: There were 15 healthy male volunteers who were exposed to 4 10-min protocols in which they received air in the supine position (Placebo/Supine), 3% carbon dioxide (CO2) in the supine position (CO2/Supine), air with -10° HDT (Placebo/HDT) and 3% CO2 with -10° HDT (CO2/HDT). Dynamic cerebral autoregulation was evaluated using a transfer function analysis of the beat-to-beat variability in mean arterial blood pressure (ABP) and mean cerebral blood flow (CBF) velocity. RESULTS: The phase in the low-frequency range was significantly lower during CO2/HDT than all other protocols, where CO2/HDT was -25% lower than Placebo/Supine (CO2/HDT, 0.49 ± 0.21; Placebo/Supine, 0.65 ± 0.16 radians). The transfer function gain in the low-frequency range was significantly higher during CO2/HDT than all other protocols, where CO2/HDT was 26% higher than Placebo/Supine (CO2/HDT, 1.08 ± 0.34; Placebo/Supine, 0.86 ± 0.28 cm · s-1 · mmHg-1). However, neither the CO2/Supine nor Placebo/HDT showed significant differences compared with the Placebo/Supine. DISCUSSION: Even short-term exposure to 3% CO2 plus HDT increased synchrony and the magnitude of transmission between ABP and CBF in the low-frequency range. Thus, the combination of mild hypercapnia and a cephalad fluid shift attenuated dynamic cerebral autoregulation.Kurazumi T, Ogawa Y, Yanagida R, Morisaki H, Iwasaki K. Dynamic cerebral autoregulation during the combination of mild hypercapnia and cephalad fluid shift. Aerosp Med Hum Perform. 2017; 88(9):819-826.
[Mh] Termos MeSH primário: Circulação Cerebrovascular/fisiologia
Deslocamentos de Líquidos Corporais/fisiologia
Decúbito Inclinado com Rebaixamento da Cabeça/fisiologia
Homeostase/fisiologia
Hipercapnia/fisiopatologia
[Mh] Termos MeSH secundário: Voluntários Saudáveis
Seres Humanos
Masculino
Ultrassonografia Doppler Transcraniana
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM; S
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.3357/AMHP.4870.2017


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[PMID]:28441922
[Au] Autor:van Noort K; Schuurmann RC; Wermelink B; Slump CH; Kuijpers KC; de Vries JP
[Ad] Endereço:1 Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
[Ti] Título:Fluid displacement from intraluminal thrombus of abdominal aortic aneurysm as a result of uniform compression.
[So] Source:Vascular;25(5):542-548, 2017 Oct.
[Is] ISSN:1708-539X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives The results after aneurysm repair with an endovascular aneurysm sealing (EVAS) system are dependent on the stability of the aneurysm sac and particularly the intraluminal abdominal aortic thrombus (ILT). The postprocedural ILT volume is decreased compared with preprocedural ILT volume in aortic aneurysm patients treated with EVAS. We hypothesize that ILT is not stable in all patients and pressurization of the ILT may result in displacement of fluids from the ILT, no differently than serum is displaced from whole blood when it settles. To date, the mechanism and quantification of fluid displacement from ILT are unknown. Methods The study included 21 patients who underwent elective open abdominal aortic aneurysm repair. The ILT was harvested as a routine procedure during the operation. After excision of a histologic sample of the ILT specimen in four patients, ILT volume was measured and the ILT was compressed in a dedicated compression setup designed to apply uniform compression of 200 mmHg for 5 min. After compression, the volumes of the remaining thrombus and the displaced fluid were measured. Results The median (interquartile-range) of ILT volume before compression was 60 (66) mL, and a median of 5.7 (8.4) mL of fluid was displaced from the ILT after compression, resulting in a median thrombus volume decrease of 11% (10%). Fluid components can be up to 31% of the entire ILT volume. Histologic examination of four ILT specimens showed a reduction of the medial layer of the ILT after compression, which was the result of compression of fluid-containing canaliculi. Conclusions Applying pressure of 200 mmHg to abdominal aortic aneurysm ILT resulted in the displacement of fluid, with a large variation among patients. Fluid displacement may result in decrease of ILT volume during and after EVAS, which might have implications on pre-EVAS volume planning and on stability of the endobags during follow-up which may lead to migration, endoleak or both.
[Mh] Termos MeSH primário: Aneurisma da Aorta Abdominal/cirurgia
Implante de Prótese Vascular
Deslocamentos de Líquidos Corporais
Trombose/patologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Aneurisma da Aorta Abdominal/complicações
Aneurisma da Aorta Abdominal/patologia
Biópsia
Implante de Prótese Vascular/efeitos adversos
Procedimentos Endovasculares/efeitos adversos
Feminino
Seres Humanos
Masculino
Pressão
Trombose/complicações
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1177/1708538117707612


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[PMID]:28417833
[Au] Autor:Arbeille P; Avan P; Treffel L; Zuj K; Normand H; Denise P
[Ti] Título:Jugular and Portal Vein Volume, Middle Cerebral Vein Velocity, and Intracranial Pressure in Dry Immersion.
[So] Source:Aerosp Med Hum Perform;88(5):457-462, 2017 May 01.
[Is] ISSN:2375-6314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The objective was to determine if short term exposure to dry immersion (DI) results in a cephalic fluid shift similar to what has been observed with spaceflight. METHODS: Data were collected from 10 individuals at rest and during the first 2 h of dry immersion. Jugular vein (JV), portal vein (PV), and thyroid volume were measured using 3D echography. Middle cerebral vein velocity (MCVv) was determined using transcranial Doppler ultrasound. The cochlear response to audio stimulation was used to derive an estimate of intracranial pressure (dICP). RESULTS: After 2 h of DI, there was a significant increase (mean ± SD) in JV (2.21 ± 1.10 mL), PV (1.05 ± 0.48 mL), and thyroid (0.428 ± 0.313 mL) volume. MCVv was also significantly increased with DI (3.90 ± 5.03 cm · s-1). There was no change in dICP with DI in part due to large individual variability. The range of dICP changes appeared to be related to MCVv, with participants with the largest increase in MCVv also showing increased dICP. DISCUSSION: The results suggest that DI induces a significant cephalic fluid shift similar to what is observed with spaceflight. The increased thyroid volume suggests that cerebral tissue may also be subjected to similar fluid filtration, with implications for changes in intracranial pressure. However, despite all participants having an increase in JV and thyroid volume, only half showed an increase in dICP, suggesting that increased venous pooling alone is not sufficient to cause increased intracranial pressure.Arbeille P, Avan P, Treffel L, Zuj K, Normand H, Denise P. Jugular and portal vein volume, middle cerebral vein velocity, and intracranial pressure in dry immersion. Aerosp Med Hum Perform. 2017; 88(5):457-462.
[Mh] Termos MeSH primário: Veias Cerebrais/diagnóstico por imagem
Deslocamentos de Líquidos Corporais
Pressão Intracraniana/fisiologia
Veias Jugulares/diagnóstico por imagem
Veia Porta/diagnóstico por imagem
Simulação de Ausência de Peso
[Mh] Termos MeSH secundário: Estimulação Acústica
Adulto
Medicina Aeroespacial
Velocidade do Fluxo Sanguíneo
Cóclea/fisiologia
Voluntários Saudáveis
Seres Humanos
Imagem Tridimensional
Veias Jugulares/anatomia & histologia
Masculino
Tamanho do Órgão
Veia Porta/anatomia & histologia
Voo Espacial
Ultrassonografia Doppler Transcraniana
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170615
[Lr] Data última revisão:
170615
[Sb] Subgrupo de revista:IM; S
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE
[do] DOI:10.3357/AMHP.4762.2017


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[PMID]:28300872
[Au] Autor:Li W; Xu P; Cen Y; Sun D; Yang T; Xu Q; Li S; Li Y; Ding B
[Ad] Endereço:Department of Gastrointestinal Surgery, the Second Affiliated Hospital, Kunming Medical University, China.
[Ti] Título:Impacts of albumin synergized with hydroxyethyl starch on early microvascular albumin leakage after major abdominal surgery in rabbits.
[So] Source:Acta Cir Bras;32(2):108-115, 2017 Feb.
[Is] ISSN:1678-2674
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To investigate the impacts of albumin synergized with hydroxyethyl starch (HES) on early microvascular albumin leakage after major abdominal surgery in rabbits. METHODS: Forty male Japanese rabbits were randomly divided into four groups: the control group, the saline group, the albumin group, and the Syn group (hydroxyethyl starch+albumin). The latter three groups were performed gastrectomy plus resection of pancreatic body and tail and splenectomy. The serum albumin concentration was detected before and 48h after surgery, and the conditions of mesenteric microvascular leakage in these 4 groups were observed under microscope 48 h after surgery to calculate the leakage rate. RESULTS: Compared with the saline group, the albumin group and the Syn group exhibited significantly increased serum albumin concentrations 48h after surgery (P<0.05). The albumin leakage rate was the most obvious in the albumin group, followed by the saline group, while that in the Syn group was the minimal, and there existed significant differences among these groups (P<0.05) . CONCLUSION: Simple administration of albumin in the early stage after major abdominal surgery could increase the albumin leakage, while the synergization of albumin and hydroxyethyl starch could reduce the albumin leakage.
[Mh] Termos MeSH primário: Permeabilidade Capilar/fisiologia
Derivados de Hidroxietil Amido/administração & dosagem
Albumina Sérica/administração & dosagem
Albumina Sérica/análise
[Mh] Termos MeSH secundário: Abdome/cirurgia
Animais
Sinergismo Farmacológico
Deslocamentos de Líquidos Corporais/fisiologia
Masculino
Modelos Animais
Coelhos
Distribuição Aleatória
Albumina Sérica/metabolismo
Cloreto de Sódio
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hydroxyethyl Starch Derivatives); 0 (Serum Albumin); 451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170830
[Lr] Data última revisão:
170830
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170317
[St] Status:MEDLINE


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[PMID]:28248863
[Au] Autor:Hunsicker O; Heinig S; Dathe JJ; Krannich A; Spies C; Feldheiser A
[Ad] Endereço:aDepartment of Anaesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum bDepartment of Biostatistics, Coordination Center for Clinical Trials, Charite[Combining Acute Accent]-University Medicine Berlin cBerlin Institute of Health, Clinical Research Unit-Biostatistics Unit, Berlin, Germany.
[Ti] Título:Comparison of bedside assessed arm and leg fluid filtration determined by venous congestion plethysmography in perioperative cancer patients: An observational study investigating agreement.
[So] Source:Medicine (Baltimore);96(9):e6066, 2017 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In recent years, pathophysiology and clinical impact of microvascular fluid filtration has regained interest. As the latest data in surgical patients have been published almost 20 years ago, there is need for further research to better understand fluid filtration during the perioperative period. Venous congestion plethysmography (VCP) provides a rapid and noninvasive method, which has been shown suitable for the assessment of fluid filtration in limbs. Fluid filtration assessed by VCP can be obtained from forearm and calf measurement sites, while in many clinical situations a reduced access to the patient often restricts the measurements to patient's forearm. We aimed to investigate if fluid filtration obtained from forearm and calf measurement site is interchangeable in nonsedated perioperative patients.Fluid filtration by VCP was obtained simultaneously from forearm and calf in patients with ovarian cancer at 4 time points during the perioperative course and assessed by the difference of volume changes of the limb between third and sixth minutes (VC6-3min) during venous congestion. VC6-3min obtained from forearm and calf measurement sites was compared with respect to agreement and evaluated regarding the association with the presence of leg edema.A total of 74 paired measurements were analyzed in 29 patients. Forearm VC6-3min was significantly higher than calf VC6-3min (median [25th; 75th quartile], 0.6 (0.4; 0.9) vs 0.4 [0.3; 0.6] %, P = 0.008). Bland-Altman and Polar analysis revealed a poor agreement between forearm and calf VC6-3min at predefined time points and changes of VC6-3min during the perioperative course (bias +0.23%, limits of agreement [LOA] -1.1% to 1.6%; angular bias -2.5°, radial LOA -82° to +77°). Forearm VC6-3min was significantly increased in patients with presence of leg edema (0.7 (0.5; 1.0) vs 0.5 (0.4; 0.6) %, P < 0.001) while calf VC6-3min did not differ in patients with and without edema.This study indicates that forearm and calf measurement sites are not interchangeable when bedside assessing fluid filtration by VCP in nonsedated perioperative patients. Considering that only forearm fluid filtration was related to the presence of edema, forearm measurement site should be chosen as a primary site for assessing fluid filtration.
[Mh] Termos MeSH primário: Edema/diagnóstico
Deslocamentos de Líquidos Corporais
Hiperemia/diagnóstico
Pletismografia/métodos
Complicações Pós-Operatórias/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Feminino
Antebraço
Seres Humanos
Perna (Membro)
Meia-Idade
Neoplasias Epiteliais e Glandulares/cirurgia
Neoplasias Ovarianas/cirurgia
Assistência Perioperatória
Sistemas Automatizados de Assistência Junto ao Leito
Estudos Prospectivos
[Pt] Tipo de publicação:CLINICAL TRIAL; COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170324
[Lr] Data última revisão:
170324
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170302
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006066


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[PMID]:28130294
[Au] Autor:Triacca V; Güç E; Kilarski WW; Pisano M; Swartz MA
[Ad] Endereço:From the Institute of Bioengineering and Swiss Institute for Experimental Cancer Research (ISREC), École Polytechnique Fédérale de Lausanne (V.T., E.G., W.W.K., M.P., M.A.S.); and Institute for Molecular Engineering, The University of Chicago, IL (W.W.K., M.A.S.).
[Ti] Título:Transcellular Pathways in Lymphatic Endothelial Cells Regulate Changes in Solute Transport by Fluid Stress.
[So] Source:Circ Res;120(9):1440-1452, 2017 Apr 28.
[Is] ISSN:1524-4571
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: The transport of interstitial fluid and solutes into lymphatic vessels is important for maintaining interstitial homeostasis and delivering antigens and soluble factors to the lymph node for immune surveillance. Transendothelial transport across lymphatic endothelial cells (LECs) is commonly considered to occur paracellularly, or between cell-cell junctions, and driven by local pressure and concentration gradients. However, emerging evidence suggests that LECs also play active roles in regulating interstitial solute balance and can scavenge and store antigens, raising the possibility that vesicular or transcellular pathways may be important in lymphatic solute transport. OBJECTIVE: The aim of this study was to determine the relative importance of transcellular (vesicular) versus paracellular transport pathways by LECs and how mechanical stress (ie, fluid flow conditioning) alters either pathway. METHODS AND RESULTS: We demonstrate that transcellular transport mechanisms substantially contribute to lymphatic solute transport and that solute uptake occurs in both caveolae- and clathrin-coated vesicles. In vivo, intracelluar uptake of fluorescently labeled albumin after intradermal injection by LECs was similar to that of dermal dendritic cells. In vitro, we developed a method to differentially quantify intracellular solute uptake versus transendothelial transport by LECs. LECs preconditioned to 1 µm/s transmural flow demonstrated increased uptake and basal-to-apical solute transport, which could be substantially reversed by blocking dynamin-dependent vesicle formation. CONCLUSIONS: These findings reveal the importance of intracellular transport in steady-state lymph formation and suggest that LECs use transcellular mechanisms in parallel to the well-described paracellular route to modulate solute transport from the interstitium according to biomechanical cues.
[Mh] Termos MeSH primário: Células Endoteliais/metabolismo
Endotélio Linfático/metabolismo
Líquido Extracelular/metabolismo
Deslocamentos de Líquidos Corporais
Soroalbumina Bovina/metabolismo
Albumina Sérica/metabolismo
Pele/metabolismo
Transcitose
[Mh] Termos MeSH secundário: Animais
Cavéolas/metabolismo
Vesículas Revestidas por Clatrina/metabolismo
Células Endoteliais/ultraestrutura
Endotélio Linfático/ultraestrutura
Feminino
Seres Humanos
Injeções Intradérmicas
Masculino
Camundongos Endogâmicos BALB C
Permeabilidade
Albumina Sérica/administração & dosagem
Soroalbumina Bovina/administração & dosagem
Albumina Sérica Humana
Pele/ultraestrutura
Estresse Mecânico
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Nm] Nome de substância:
0 (ALB protein, human); 0 (Serum Albumin); 27432CM55Q (Serum Albumin, Bovine); ZIF514RVZR (Serum Albumin, Human)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170129
[St] Status:MEDLINE
[do] DOI:10.1161/CIRCRESAHA.116.309828


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[PMID]:28057850
[Au] Autor:Carlisle T; Ward NR; Atalla A; Cowie MR; Simonds AK; Morrell MJ
[Ad] Endereço:Academic Unit of Sleep and Breathing, National Heart and Lung Institute, Imperial College London, London, UK t.carlisle@nhs.net.
[Ti] Título:Investigation of the link between fluid shift and airway collapsibility as a mechanism for obstructive sleep apnea in congestive heart failure.
[So] Source:Physiol Rep;5(1), 2017 Jan.
[Is] ISSN:2051-817X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The increased prevalence of obstructive sleep apnea (OSA) in congestive heart failure (CHF) may be associated with rostral fluid shift. We investigated the effect of overnight rostral fluid shift on pharyngeal collapsibility (Pcrit), pharyngeal caliber (APmean), and apnea-hypopnea index (AHI) in CHF patients. Twenty-three optimally treated systolic CHF patients were studied. Neck circumference was measured immediately prior to sleep in the evening and immediately after waking in the morning as a marker of rostral fluid shift. Pcrit was measured during sleep, early and late in the night. APmean was measured using acoustic reflection at the same times as neck circumference measurements. 15/23 CHF patients experienced an overnight increase in neck circumference; overall neck circumference significantly increased overnight (mean±SD, evening: 41.7 ± 3.2 cm; morning: 42.3 ± 3.1 cm; P = 0.03). Pcrit increased significantly overnight (early-night: -3.8 ± 3.3 cmH O; late-night: -2.6 ± 3.0 cmH O; P = 0.03) and APmean decreased (evening: 4.2 ± 1.3 cm ; morning: 3.7 ± 1.3 cm ; P = 0.006). The total AHI correlated with neck circumference (r = 0.4; P = 0.04) and Pcrit (r = 0.5; P = 0.01). APmean correlated with neck circumference (r = -0.47; P = 0.02). There was no significant change in AHI between the first and second half of the night (first-half: 12.9 ± 12.4/h; second-half: 13.7 ± 13.3/h; P = 0.6). Overnight rostral fluid shift was associated with increased pharyngeal collapsibility and decreased pharyngeal caliber during sleep in CHF patients. Rostral fluid shift may be an important mechanism of OSA in this patient group.
[Mh] Termos MeSH primário: Obstrução das Vias Respiratórias/fisiopatologia
Deslocamentos de Líquidos Corporais/fisiologia
Insuficiência Cardíaca/fisiopatologia
Apneia Obstrutiva do Sono/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Feminino
Insuficiência Cardíaca/complicações
Seres Humanos
Masculino
Meia-Idade
Pescoço/anatomia & histologia
Faringe/fisiopatologia
Polissonografia
Prevalência
Sono/fisiologia
Apneia Obstrutiva do Sono/complicações
Apneia Obstrutiva do Sono/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170107
[St] Status:MEDLINE


  9 / 528 MEDLINE  
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[PMID]:28000175
[Au] Autor:Tanaka K; Nishimura N; Kawai Y
[Ad] Endereço:Graduate School of Health and Medicine, Gifu University of Medical Science, 795-1 Nagamine Ichihiraga, Seki, Gifu, 501-3892, Japan. ktanaka@u-gifu-ms.ac.jp.
[Ti] Título:Adaptation to microgravity, deconditioning, and countermeasures.
[So] Source:J Physiol Sci;67(2):271-281, 2017 Mar.
[Is] ISSN:1880-6562
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Humans are generally in standing or sitting positions on Earth during the day. The musculoskeletal system supports these positions and also allows motion. Gravity acting in the longitudinal direction of the body generates a hydrostatic pressure difference and induces footward fluid shift. The vestibular system senses the gravity of the body and reflexively controls the organs. During spaceflight or exposure to microgravity, the load on the musculoskeletal system and hydrostatic pressure difference is diminished. Thus, the skeletal muscle, particularly in the lower limbs, is atrophied, and bone minerals are lost via urinary excretion. In addition, the heart is atrophied, and the plasma volume is decreased, which may induce orthostatic intolerance. Vestibular-related control also declines; in particular, the otolith organs are more susceptible to exposure to microgravity than the semicircular canals. Using an advanced resistive exercise device with administration of bisphosphonate is an effective countermeasure against bone deconditioning. However, atrophy of skeletal muscle and the heart has not been completely prevented. Further ingenuity is needed in designing countermeasures for muscular, cardiovascular, and vestibular dysfunctions.
[Mh] Termos MeSH primário: Adaptação Fisiológica/fisiologia
[Mh] Termos MeSH secundário: Animais
Deslocamentos de Líquidos Corporais/fisiologia
Seres Humanos
Músculo Esquelético/fisiologia
Voo Espacial
Ausência de Peso
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161222
[St] Status:MEDLINE
[do] DOI:10.1007/s12576-016-0514-8


  10 / 528 MEDLINE  
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[PMID]:27586123
[Au] Autor:Basile C; Davenport A; Blankestijn PJ
[Ad] Endereço:Division of Nephrology, Clinical Research Branch, Miulli General Hospital, 70121, Acquaviva delle Fonti, Italy. basile.miulli@libero.it.
[Ti] Título:Why choose high volume online post-dilution hemodiafiltration?
[So] Source:J Nephrol;30(2):181-186, 2017 Apr.
[Is] ISSN:1724-6059
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:The mortality rate of patients on maintenance dialysis remains alarmingly high, at approximately 15-20 % per year. Increasing dialyzer urea clearance has not been shown to improve survival and hence interest has shifted towards convective therapies, such as hemodiafiltration (HDF) which can remove middle molecular weight uremic toxins, which have been suggested to increase mortality in patients with end-stage kidney disease. During the last few years, four large prospective randomized controlled trials (RCTs) have been conducted in different European countries to compare survival outcomes in prevalent patients receiving conventional hemodialysis with online post-dilution HDF (OL HDF). Furthermore, a pooled individual participant data analysis from four RCTs was performed and four large meta-analyses on convective therapies have been published in the last 2 years. Taken together, these studies support the conclusion that high volume post-dilution OL HDF is associated with improved overall survival. This advantage results predominantly from a lower cardiovascular mortality, possibly due to better preservation of left ventricle mass and function. Improved intra-dialytic blood pressure stability may contribute to the beneficial effect of high volume post-dilution OL HDF on survival. The beneficial effect is not restricted to selected subgroups, such as age, comorbidity or dialysis vintage. There is no compelling evidence that high volume post-dilution OL HDF reduces mortality by improvements in traditional and non-traditional risk factors. There are still no studies or case reports published describing adverse clinical outcomes in more than 20 years of HDF clinical experience. In conclusion, most of the available data support the choice of high volume post-dilution HDF over the current dialysis techniques. However, considering that we live in the era of evidence-based medicine, the evidence supporting the superiority of high volume post-dilution OL HDF in comparison to hemodialysis is still missing: in fact, a new RCT targeting different convection volumes would be needed to definitively examine the dose-response effect shown in previous studies.
[Mh] Termos MeSH primário: Água Corporal/metabolismo
Deslocamentos de Líquidos Corporais
Hemodiafiltração/métodos
Falência Renal Crônica/terapia
Rim/fisiopatologia
Equilíbrio Hidroeletrolítico
[Mh] Termos MeSH secundário: Convecção
Hemodiafiltração/efeitos adversos
Hemodiafiltração/mortalidade
Hemodinâmica
Seres Humanos
Rim/irrigação sanguínea
Falência Renal Crônica/diagnóstico
Falência Renal Crônica/mortalidade
Falência Renal Crônica/fisiopatologia
Circulação Renal
Fatores de Risco
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171115
[Lr] Data última revisão:
171115
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160903
[St] Status:MEDLINE
[do] DOI:10.1007/s40620-016-0343-0



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