ABSTRACT
Introduction: The knowledge of the prevalence of risk factors and comorbidities, as well as the evolution and complications in patients undergoing coronary artery bypass graft allows comparison between institutions and evidence of changes in the profile of patients and postoperative evolution over time. Objective: To profile (risk factors and comorbidities) and clinical outcome (complications) in patients undergoing coronary artery bypass graft in a national institution of great surgical volume. Methods: A retrospective cohort study of patients undergoing coronary artery bypass graft in the hospital Beneficência Portuguesa de São Paulo, from July 2009 to July 2010. Results: We included 3,010 patients, mean age of 62.2 years and 69.9% male. 83.8% of patients were hypertensive, 36.6% diabetic, 44.5% had dyslipidemia, 15.3% were smokers, 65.7% were overweight/obese, 29.3% had a family history of coronary heart disease. The expected mortality calculated by logistic EuroSCORE was 2.7%. The isolated CABG occurred in 89.3% and 11.9% surgery was performed without cardiopulmonary bypass. The most common complication was cardiac arrhythmia (18.7%), especially acute atrial fibrillation (14.3%). Pneumonia occurred in 6.2% of patients, acute renal failure in 4.4%, mediastinites in 2.1%, stroke in 1.8% and AMI in 1.2%. The in-hospital mortality was 5.4% and in isolated coronary artery bypass graft was 3.5%. The average hospital stay was 11 days with a median of eight days (3-244 days). Conclusion: The profile of patients undergoing coronary artery bypass graft surgery in this study is similar to other published studies. .
Introdução: O conhecimento da prevalência dos fatores de risco e comorbidades, bem como a evolução com complicações nos pacientes submetidos à cirurgia de revascularização miocárdica, permite a comparação entre instituições e a comprovação de modificações no perfil de pacientes e na evolução pós-operatória ao longo do tempo. Objetivo: Conhecer o perfil (fatores de risco e comorbidades) e a evolução clínica (complicações) nos pacientes submetidos à cirurgia de revascularização miocárdica em uma instituição nacional de grande volume cirúrgico. Métodos: Estudo de coorte retrospectivo de pacientes submetidos ao procedimento de cirurgia de revascularização miocárdica no Hospital Beneficência Portuguesa de São Paulo, no período de julho de 2009 a julho de 2010. Resultados: Foram incluídos 3010 pacientes, com idade média de 62,2 anos e 69,9% do sexo masculino. 82,8% dos pacientes eram hipertensos, 36,6% diabéticos, 44,5% dislipidêmicos, 15,3% tabagistas, 65,7% com sobrepeso/obesidade e 29,3% tinham antecedentes familiares de doença coronária. A mortalidade média esperada calculada pelo EuroSCORE logístico foi de 2,7%. A cirurgia de revascularização miocárdica isolada ocorreu em 89,3% e em 11,9% foi realizada cirurgia sem circulação extracorpórea. A complicação mais comum foi arritmia cardíaca (18,7%), especialmente a fibrilação atrial aguda (14,3%). Pneumonia ocorreu em 6,2% dos pacientes, lesão renal aguda em 4,4%, mediastinite em 2,1%, acidente vascular encefálico em 1,8% e infarto agudo do miocárdio em 1,2%. A mortalidade intra-hospitalar foi de 5,4% e na cirurgia de revascularização miocárdica isolada foi de 3,5%. O tempo de permanência hospitalar médio foi de 11 dias, com mediana de oito dias (3 - 244 dias). Conclusão: O perfil dos pacientes submetidos à cirurgia de revascularização miocárdica neste estudo assemelha-se ao de outros estudos publicados. .
Subject(s)
Animals , Humans , Mice , Gene Expression Profiling , Muscle, Skeletal/pathology , Muscular Atrophy/genetics , Triterpenes/pharmacology , Cell Line , Fasting , Gene Expression Regulation , Gene Expression/drug effects , Hindlimb/innervation , Insulin-Like Growth Factor I/metabolism , Insulin/metabolism , Muscle Denervation , Muscle Fibers, Skeletal/drug effects , Muscle Fibers, Skeletal/metabolism , Muscle Strength/drug effects , Muscle, Skeletal/drug effects , Muscle, Skeletal/metabolism , Muscular Atrophy/drug therapy , Muscular Atrophy/metabolism , Oligonucleotide Array Sequence Analysis , Signal Transduction/drug effectsABSTRACT
We evaluated the effects of chronic allergic airway inflammation and of treadmill training (12 weeks) of low and moderate intensity on muscle fiber cross-sectional area and mRNA levels of atrogin-1 and MuRF1 in the mouse tibialis anterior muscle. Six 4-month-old male BALB/c mice (28.5 ± 0.8 g) per group were examined: 1) control, non-sensitized and non-trained (C); 2) ovalbumin sensitized (OA, 20 µg per mouse); 3) non-sensitized and trained at 50 percent maximum speed _ low intensity (PT50 percent); 4) non-sensitized and trained at 75 percent maximum speed _ moderate intensity (PT75 percent); 5) OA-sensitized and trained at 50 percent (OA+PT50 percent), 6) OA-sensitized and trained at 75 percent (OA+PT75 percent). There was no difference in muscle fiber cross-sectional area among groups and no difference in atrogin-1 and MuRF1 expression between C and OA groups. All exercised groups showed significantly decreased expression of atrogin-1 compared to C (1.01 ± 0.2-fold): PT50 percent = 0.71 ± 0.12-fold; OA+PT50 percent = 0.74 ± 0.03-fold; PT75 percent = 0.71 ± 0.09-fold; OA+PT75 percent = 0.74 ± 0.09-fold. Similarly significant results were obtained regarding MuRF1 gene expression compared to C (1.01 ± 0.23-fold): PT50 percent = 0.53 ± 0.20-fold; OA+PT50 percent = 0.55 ± 0.11-fold; PT75 percent = 0.35 ± 0.15-fold; OA+PT75 percent = 0.37 ± 0.08-fold. A short period of OA did not induce skeletal muscle atrophy in the mouse tibialis anterior muscle and aerobic training at low and moderate intensity negatively regulates the atrophy pathway in skeletal muscle of healthy mice or mice with allergic lung inflammation.
Subject(s)
Animals , Male , Mice , Asthma/pathology , Muscle Proteins/analysis , Muscle, Skeletal/chemistry , Muscular Atrophy/pathology , RNA, Messenger/analysis , SKP Cullin F-Box Protein Ligases/analysis , Ubiquitin-Protein Ligases/analysis , Asthma/physiopathology , Chronic Disease , Disease Models, Animal , Gene Expression , Mice, Inbred BALB C , Muscle Fibers, Skeletal/chemistry , Muscle Fibers, Skeletal/pathology , Muscle, Skeletal/pathology , Muscular Atrophy/genetics , Muscular Atrophy/physiopathology , Physical Conditioning, Animal , Pneumonia/metabolism , Pneumonia/pathology , TibiaABSTRACT
Cyclosporin-A (CsA) is an immunosuppressive drug that acts as an inhibitor of calcineurin, a calcium phosphatase that has been suggested to play a role in skeletal muscle hypertrophy. The aim of the present study was to determine the effect of CsA administration (25 mg kg-1 day-1) on skeletal muscle mass and phenotype during disuse and recovery. Male Wistar rats received vehicle (N = 8) or CsA (N = 8) during hind limb immobilization (N = 8) and recovery (N = 8). Muscle weight (dry/wet) and cross-sectional area were evaluated to verify the effect of CsA treatment on muscle mass. Muscle phenotype was assessed by histochemistry of myosin ATPase. CsA administration during immobilization and recovery did not change muscle/body weight ratio in the soleus (SOL) or plantaris (PL). Regarding muscle phenotype, we observed a consistent slow-to-fast shift in all experimental groups (immobilized only, receiving CsA only, and immobilized receiving CsA) as compared to control in both SOL and PL (P < 0.05). During recovery, no difference was observed in SOL or PL fiber type composition between the experimental recovered group and recovered group receiving CsA compared to their respective controls. Considering the muscle/body weight ratio, CsA administration does not maximize muscle mass loss induced by immobilization. Our results also indicate that CsA fails to block skeletal muscle regrowth after disuse. The present data suggest that calcineurin inhibition by CsA modulates muscle phenotype rather than muscle mass.
Subject(s)
Animals , Male , Rats , Calcineurin/antagonists & inhibitors , Cyclosporine/pharmacology , Enzyme Inhibitors/pharmacology , Muscle, Skeletal/drug effects , Hindlimb Suspension , Muscle Fibers, Skeletal , Muscle, Skeletal/pathology , Muscular Atrophy/genetics , Muscular Atrophy/pathology , Phenotype , Polymerase Chain Reaction , Rats, WistarABSTRACT
La enfermedad de Werdning-Hoffmann o Atrofia Muscular Espinal, se caracteriza por cursar con hipotonía, debilidad muscular y disminución o ausencia de los refejos osteo-tendinosos. Se presenta a una lactante mayor, femenina de 20 meses, referida como "Síndrome del Niño Hipotónico", con hipotonía y debilidad muscular, para su evaluación genética. Fue estudiada clínica y paraclínicamente, siendo portadora de una Enfermedad de Werdnig-Hoffmann. Fallece a los 20 meses a consecuencia de un cuadro respiratorio bronconeumónico. La madre refiere cuatro hijos anteriores (dos varones y dos hembras) con igual cuadro neurológico, falleciendo alrededor de los 14 meses de edad, por cuadros respiratorios. Aun cuando, clásicamente, la Atrofia Muscular Espinal es transmitida mediante patrón mendeliano autosómico recesivo, casos de dominancia han sido reportados en la literatura. Es de hacer notar la frecuencia de pacientes afectos (cinco de un total de ocho hijos) en el grupo familiar en estudio