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2.
Bol. latinoam. Caribe plantas med. aromát ; 20(5): 524-535, sept. 2021. tab, ilus
Article in English | LILACS | ID: biblio-1369071

ABSTRACT

Microsechium helleri (Cucurbitaceae) has been used in ethnopharmacological as a lotion to prevent hair loss, diuretic and cathartic, in the region of central Veracruz, Mexico is used as antidiabetic. The antioxidant properties of the hexanic (EHex), chloroformic (ECHCl3) and ethanolic (EEtOH) extracts, were evaluated by 2,2diphenyl-1-pychrylhydrazyl (DPPH) test, the Ferric Reducing/Antioxidant Power (FRAP) and the total phenolic content test. The anti-inflammatory effect was evaluated in the acute ear edema induced with phorbol 12-myristate 13-acetate (TPA) in mouse and the hypoglycemic and cardioprotective effects of the EEtOH were determined in rats. The EEtOH was the most active in the antioxidant potential DPPH test and the ECHCl3 was the best in the FRAP assay and the total polyphenols content. In the anti-inflammatory assay, the ECHCl3 showed the most activity. The EEtOH had the decreased the glucose levels and reduced myocardial damage. The results support the use of this plant in folk medicine in Mexico as antioxidant, anti-inflammatory, hypoglycemic and cardioprotective.


Microsechium helleri (Cucurbitaceae) se utiliza en etnofarmacología como una loción para prevenir la caída del cabello, como diurético y catártico, en la región del centro de Veracruz, México es usado como antidiabético. Las propiedades antioxidantes de los extractos hexánico (EHex), clorofórmico (ECHCl3) y etanólico (EEtOH), se evaluaron mediante la prueba de 2,2difenil-1-psililhidrazilo (DPPH), el poder reductor férrico/poder antioxidante (FRAP) y el contenido fenólico total. El efecto anti-inflamatorio se evaluó en el edema agudo de la oreja inducido con forbol 12-miristato 13-acetato (TPA) en ratones y se determinaron los efectos hipoglucémicos y cardioprotectores del EEtOH en ratas. El EEtOH fue el más activo en la prueba DPPH de potencial antioxidante y el ECHCl3 fue el mejor en el ensayo FRAP y el contenido total de polifenoles. En el ensayo antiinflamatorio, el ECHCl3 mostró la mayor actividad. El EEtOH disminuyó los niveles de glucosa y redujo el daño miocárdico. Los efectos hipoglucémicos y cardioprotector del extracto de EEtOH se determinaron en ratas, donde el extracto disminuyó los niveles de glucosa y redujo el daño miocárdico. Los resultados apoyan el uso de esta planta en la medicina popular en México como antioxidante, anti-inflamatorio, hipoglucemiante y cardioprotector.


Subject(s)
Plant Extracts/pharmacology , Cardiotonic Agents/pharmacology , Cucurbitaceae/chemistry , Hypoglycemic Agents/pharmacology , Anti-Inflammatory Agents/pharmacology , Plant Extracts/chemistry , Cardiotonic Agents/chemistry , Free Radical Scavengers , Phenolic Compounds/analysis , Hypoglycemic Agents/chemistry , Medicine, Traditional , Mexico , Anti-Inflammatory Agents/chemistry
3.
Rev. Hosp. Ital. B. Aires (2004) ; 41(1): 26-30, mar. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1178336

ABSTRACT

El pioderma gangrenoso ampollar es una variedad infrecuente de pioderma gangrenoso, que se asocia en el 50-70% de los casos con trastornos oncohematológicos. Se comunica el caso de una paciente de 59 años, que consultó por fiebre y ampollas purpúricas de rápida progresión, con compromiso cutáneo mucoso. Con sospecha de una enfermedad neutrofílica, ampollar, o infección por gérmenes oportunistas, se realizó biopsia de piel para estudio histopatológico, inmunofluorescencia directa y cultivo. Los cultivos y la inmunofluorescencia directa fueron negativos, y la anatomía patológica reveló un denso infiltrado inflamatorio con predominio neutrofílico en dermis. Ante el diagnóstico de pioderma gangrenoso ampollar, se realizó una punción-aspiración de médula ósea cuyo resultado fue compatible con leucemia mieloide aguda. Se instauró tratamiento con corticosteroides sistémicos, a pesar de lo cual la paciente evolucionó desfavorablemente y falleció a los 15 días de su ingreso hospitalario. Este caso ilustra la asociación de esta enfermedad cutánea con trastornos oncohematológicos y el mal pronóstico que esto implica a corto plazo. (AU)


Bullous pyoderma gangrenosum is an infrequent type of pyoderma gangrenosum, associated with onco hematological diseases in 50-70% of cases. We present the case of a 59-year-old patient with fever and mucocutaneous hemorrhagic bullous of rapid progression. A biopsy for histopathology, direct immunofluorescence (DIF) and skin culture was made, considering the possibility of neutrophilic dermatoses, bullous dermatosis or an opportunistic infection. The results of both the culture and the DIF were negative. The histopathological examination of the specimen revealed a dense dermal polymorphic infiltrate composed primarily of neutrophils. Considering bullous pyoderma gangrenosum as a potential diagnosis, a bone-marrow biopsy was performed. This study revealed an acute myeloid leukemia. Although systemic corticosteroid therapy was begun, the patient presented an unfavorable evolution that led to her death 15 days after her admission at the hospital. This case shows the association between bullous pyoderma gangrenosum and onco hematological diseases. In addition, it highlights the poor prognosis related to these diseases in the short term. (AU)


Subject(s)
Humans , Female , Middle Aged , Leukemia, Myeloid, Acute/pathology , Pyoderma Gangrenosum/diagnosis , Paraneoplastic Syndromes/pathology , Respiration, Artificial , Azacitidine/therapeutic use , Myelodysplastic Syndromes/pathology , Acyclovir/administration & dosage , Methylprednisolone/administration & dosage , Vancomycin/administration & dosage , Cardiotonic Agents/therapeutic use , Ceftazidime/administration & dosage , Amphotericin B/administration & dosage , Imipenem/administration & dosage , Sweet Syndrome/etiology , Pyoderma Gangrenosum/etiology , Pyoderma Gangrenosum/pathology , Pyoderma Gangrenosum/drug therapy , Adrenal Cortex Hormones/therapeutic use , Meropenem/administration & dosage
4.
Acta Physiologica Sinica ; (6): 878-884, 2021.
Article in Chinese | WPRIM | ID: wpr-921291

ABSTRACT

The aim of the present study was to investigate the protective effect of propofol on the experimental myocardial infarction in rats. The myocardial infarction model was established by ligating the anterior descending branch of left coronary artery in rats. Model rats were treated with propofol. Cardiac function was evaluated by echocardiography. Cardiac hemodynamic changes were detected by multiconductor biorecorder. Pathological changes in the infarcted myocardia were detected by HE staining. The expression levels of cardiac hypertrophy marker genes and fibrosis marker proteins were analyzed by real-time quantitative PCR and Western blot. The results showed that, compared with the sham surgery group, the model group exhibited larger infarct size (> 40%), impaired heart function, and significantly increased left ventricular end-diastolic pressure (LVEDP). Propofol reduced cardiac function impairment and decreased LVEDP in the model group. Propofol significantly reduced lung weight/body weight ratio, heart weight/body weight ratio, left ventricular weight/body weight ratio and left atrial weight/body weight ratio in the model group. Furthermore, after myocardial infarction, the administration of propofol significantly improved the diastolic strain rate, down-regulated the mRNA expression levels of myocardial hypertrophy markers, atrial natriuretic peptide and β-myosin heavy chain, and reversed the up-regulation of matrix metalloproteinase 2 (MMP2), MMP9 and tissue inhibitor of metalloproteinase-2 (TIMP-2) induced by myocardial infarction. These results suggest propofol can reduce adverse ventricular remodeling, cardiac dysfunction, myocardial hypertrophy and fibrosis after myocardial infarction, and has protective effect against the experimental myocardial infarction induced by coronary artery ligation in rats.


Subject(s)
Animals , Cardiotonic Agents/pharmacology , Matrix Metalloproteinase 2 , Matrix Metalloproteinase 9 , Myocardial Infarction/drug therapy , Myocardium , Propofol/pharmacology , Rats , Tissue Inhibitor of Metalloproteinase-2/genetics , Ventricular Remodeling
5.
Enferm. foco (Brasília) ; 11(5): 194-199, dez. 2020. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1177753

ABSTRACT

Objetivo: detalhar a etapa metodológica de validação de conteúdo por enfermeiros na construção de um aplicativo sobre drogas cardiotônicas. Método: trata-se de um estudo metodológico com abordagem quantitativa, constituído por duas etapas: seleção dos medicamentos cardiotônicos (noradrenalina, dobutamina, nitroprussiato de sódio, nitroglicerina, amiodarona, atenolol, losartana, captopril, atensina e anlodipino), identificados a partir de um estudo exploratório em unidade de terapia intensiva; e metodológica, com avaliação de concordância de conteúdo por nove enfermeiros intensivistas mediante um formulário online, com conteúdo disposto em escala tipo Likert. A coleta de dados ocorreu em outubro de 2019, sendo adotada a validade de um item maior ou igual a 0,70. Resultados: o índice global de validação de concordância foi de 0,94, atestando a confiabilidade dos conteúdos dos medicamentos cardiotônicos, visando promover uma prática clínica segura de enfermagem. Conclusão: pode-se inferir que o posterior desenvolvimento do aplicativo móvel a partir do conteúdo validado pode promover uma assistência de qualidade para o profissional, auxiliando na tomada de decisão e promovendo a segurança do paciente de terapia intensiva. (AU)


Objective: To detail the methodological stage of content validation, by nurses, in the construction of an application on cardiotonic drugs. Methods: This is a methodological study with a quantitative approach, consisting of two stages: selection of cardiotonic drugs (noradrenaline, dobutamine, sodium nitroprusside, nitroglycerin, amiodarone, atenolol, losartan, captopril, atensin and amlodipine), identified from an exploratory study in an intensive care unit; and methodological with content agreement assessment by nine intensive care nurses, using an online form, with content arranged on a Likert scale. Data collection took place in October 2019, with the validity of an item greater than or equal to 0.70 being adopted. Results: The global agreement validation index was 0.94, attesting the reliability of the content of cardiotonic drugs, aiming to promote a safe clinical practice in nursing. Conclusion: it can be inferred that the subsequent development of the mobile application, based on the validated content, can promote quality care for the professional, assisting in decision making and promoting the safety of intensive care patients. (AU)


Objetivo: Detallarla etapa metodológica de lavalidación de contenido por parte de lasenfermerasenlaconstrucción de una aplicación de medicamentos cardiotónicos. Métodos: Este es unestudio metodológico conun enfoque cuantitativo, que consta de dos etapas: selección de fármacos cardiotónicos (noradrenalina, dobutamina, nitroprusiato de sodio, nitroglicerina, amiodarona, atenolol, losartán, captopril, atensina y amlodipino), identificados a partir de unestudioexploratorioen una unidad de cuidados intensivos; y evaluación metodológica conacuerdo de contenido por 09 (nueve) enfermeras de cuidados intensivos, utilizando unformularioen línea concontenido organizado en una escala Likert. La recopilación de datos se llevó a cabo del 13 al 25 de octubre de 2019, conla validez de un artículo mayor o igual a 0.70. Resultados: El índice de validacióndelacuerdo global fue de 0.94, lo que demuestralaconfiabilidaddelcontenido de medicamentos cardiotónicos, conel objetivo de promover una práctica clínica segura enenfermería. Conclusión: Se puede inferir que eldesarrollo posterior de laaplicaciónmóvil a partir delcontenido validado puede promover una atención de calidadpara elprofesional, ayudandoenla toma de decisiones y promoviendolaseguridad de los pacientes de cuidados intensivos. (AU)


Subject(s)
Nursing , Cardiotonic Agents , Validation Study , Drug Interactions , Mobile Applications
6.
Electron. j. biotechnol ; 45: 46-52, May 15, 2020. tab, graf, ilus
Article in English | LILACS | ID: biblio-1177424

ABSTRACT

BACKGROUND: The present study analyzed the synergistic protective effect of ß-alanine and taurine against myocardial ischemia/reperfusion. Myocardial infarct size, lipid peroxidation, and levels of glutathione peroxidase (Gpx), superoxide dismutase (SOD), reduced glutathione (GSH), catalase, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), reactive oxygen species (ROS), apoptosis, and the mRNA and protein expression of Janus kinase 2 (JAK2) and signal transducer and activator 3 of transcription (STAT3) were determined. The molecular docking was carried out by using AutoDock 4.2.1. RESULTS: Combined treatment with ß-alanine and taurine reduced myocardial infarct size, lipid peroxidation, inflammatory marker, ROS levels, and apoptosis and increased Gpx, SOD activity, GSH, and catalase activity. Furthermore, combined treatment significantly reduced JAK2 and STAT3 mRNA and protein expression compared with the control. The small molecule was docked over the SH2 domain of a STAT3, and binding mode was determined to investigate the inhibitory potential of ß-alanine and taurine. ß-Alanine bound to SH2 domain with ΔG of -7.34 kcal/mol and KI of 1.91 µM. Taurine bound to SH2 domain with ΔG of -7.38 kcal/mol and KI of 1.95 µM. CONCLUSION: Taken together, these results suggest that the combined supplementation of ß-alanine and taurine should be further investigated as an effective therapeutic approach in achieving cardioprotection in myocardial ischemia/reperfusion.


Subject(s)
Animals , Male , Rats , Taurine/therapeutic use , Cardiotonic Agents/therapeutic use , Reperfusion Injury/drug therapy , beta-Alanine/therapeutic use , Myocardial Ischemia/drug therapy , Superoxide Dismutase , Immunohistochemistry , Lipid Peroxidation , Reactive Oxygen Species , Rats, Wistar , Reverse Transcriptase Polymerase Chain Reaction , Disease Models, Animal , Janus Kinase 2 , Molecular Docking Simulation , Glutathione Peroxidase , Heart Diseases/drug therapy , Inflammation
7.
Article in English | WPRIM | ID: wpr-881036

ABSTRACT

Cardiovascular disease is the main cause of mortality and morbidity in the world, especially in developing countries. Drug therapy is one of the main ways to treat cardiovascular diseases. Among them, great progress has been made in the treatment of cardiovascular diseases with traditional Chinese medicine. In terms of experimental research, the mechanism of traditional Chinese medicine in the treatment of cardiovascular diseases has been thoroughly discussed in vitro and in vivo. In terms of clinical treatment, traditional Chinese medicine with flavonoids, saponins and alkaloids as the main effective components has a definite effect on the treatment of cardiovascular diseases such as arrhythmia, myocardial ischemia, angina pectoris and myocardial infarction, with high safety and good application prospects. With the further research on the effective ingredients, mechanism and adverse reactions of traditional Chinese medicine, it will be beneficial to the effectiveness of traditional Chinese medicine, reduce side effects and promote the modernization of traditional Chinese medicine. Calycosin and its derivatives, the main bioactive flavonoids in Astragalus membranaceus have multiple biological effects, such as antioxidant, pro-angiogenesis, anti-tumour, and anti-inflammatory effects. Based on the above biological effects, calycosin has been shown to have good potential for cardiovascular protection. The potent antioxidant effect of calycosin may play an important role in the cardiovascular protective potential. For injured cardiac myocytes, calycosin and its derivatives can alleviate the cell damage mainly marked by the release of myocardial enzymes and reduce the death level of cardiac myocytes mainly characterized by apoptosis through various mechanisms. For vascular endothelial cells, calycosin also has multiple effects and multiple mechanisms, such as promoting vascular endothelial cell proliferation, exerting vasodilating effect and directly affecting the synthesis function of endothelial cells. The present review will address the bioactivity of calycosin in cardiovascular diseases such as protective effects on cardiac myocytes and vascular endothelial cells and elucidate main mechanism of calycosin and its derivatives to exert the above biological effects.


Subject(s)
Apoptosis/drug effects , Cardiotonic Agents/pharmacology , Cardiovascular Diseases/drug therapy , Cell Proliferation/drug effects , Drugs, Chinese Herbal/pharmacology , Humans , Isoflavones/pharmacology , Medicine, Chinese Traditional , Muscle Cells/drug effects
8.
Acta cir. bras ; 34(11): e201901104, Nov. 2019. graf
Article in English | LILACS | ID: biblio-1054677

ABSTRACT

Abstract Purpose: Myocardial ischemia/reperfusion (Ml/R) injury is a leading cause of damage in cardiac tissues, with high rates of mortality and disability. Biochanin A (BCA) is a main constituent of Trifolium pratense L. This study was intended to explore the effect of BCA on Ml/R injury and explore the potential mechanism. Methods: In vivo MI/R injury was established by transient coronary ligation in Sprague-Dawley rats. Triphenyltetrazolium chloride staining (TTC) was used to measure myocardial infarct size. ELISA assay was employed to evaluate the levels of myocardial enzyme and inflammatory cytokines. Western blot assay was conducted to detect related protein levels in myocardial tissues. Results: BCA significantly ameliorated myocardial infarction area, reduced the release of myocardial enzyme levels including aspartate transaminase (AST), creatine kinase (CK-MB) and lactic dehydrogenase (LDH). It also decreased the production of inflammatory cytokines (IL-1β, IL-18, IL-6 and TNF-α) in serum of Ml/R rats. Further mechanism studies demonstrated that BCA inhibited inflammatory reaction through blocking TLR4/NF-kB/NLRP3 signaling pathway. Conclusion: The present study is the first evidence demonstrating that BCA attenuated Ml/R injury through suppressing TLR4/NF-kB/NLRP3 signaling pathway-mediated anti-inflammation pathway.


Subject(s)
Animals , Male , Cardiotonic Agents/pharmacology , Myocardial Reperfusion Injury/prevention & control , NF-kappa B/drug effects , Genistein/pharmacology , Toll-Like Receptor 4/drug effects , NLR Family, Pyrin Domain-Containing 3 Protein/drug effects , Aspartate Aminotransferases/blood , Reference Values , Myocardial Reperfusion Injury/metabolism , Signal Transduction/drug effects , Blotting, Western , Reproducibility of Results , Cytokines/blood , NF-kappa B/metabolism , Rats, Sprague-Dawley , Creatine Kinase/blood , Lactate Dehydrogenases/blood , Toll-Like Receptor 4/metabolism , Anti-Inflammatory Agents/pharmacology
9.
Acta cir. bras ; 34(11): e201901106, Nov. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054683

ABSTRACT

Abstract Purpose: To investigate whether GDF11 ameliorates myocardial ischemia reperfusion (MIR) injury in diabetic rats and explore the underlying mechanisms. Methods: Diabetic and non-diabetic rats subjected to MIR (30 min of coronary artery occlusion followed by 120 min of reperfusion) with/without GDF11 pretreatment. Cardiac function, myocardial infarct size, creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), superoxide dismutase (SOD) 15-F2tisoprostane, autophagosome, LC3II/I ratio and Belcin-1 level were determined to reflect myocardial injury, oxidative stress and autophagy, respectively. In in vitro study, H9c2 cells cultured in high glucose (HG, 30mM) suffered hypoxia reoxygenation (HR) with/without GDF11, hydrogen peroxide (H2O2) and autophagy inhibitor 3-methyladenine (3-MA) treatment, cell injury; oxidative stress and autophagy were assessed. Results: Pretreatment with GDF11 significantly improved cardiac morphology and function in diabetes, concomitant with decreased arrhythmia severity, infarct size, CK-MB, LDH and 15-F2tisoprostane release, increased SOD activity and autophagy level. In addition, GDF11 notably reduced HR injury in H9c2 cells with HG exposure, accompanied by oxidative stress reduction and autophagy up-regulation. However, those effects were completely reversed by H2O2 and 3-MA. Conclusion: GDF11 can provide protection against MIR injury in diabetic rats, and is implicated in antioxidant stress and autophagy up-regulation.


Subject(s)
Animals , Male , Autophagy/drug effects , Myocardial Reperfusion Injury/metabolism , Myocardial Reperfusion Injury/drug therapy , Oxidative Stress/drug effects , Diabetes Mellitus, Type 1/metabolism , Growth Differentiation Factors/pharmacology , Reference Values , Superoxide Dismutase/analysis , Cardiotonic Agents/pharmacology , Myocardial Reperfusion Injury/pathology , Up-Regulation/drug effects , Cell Line , Blotting, Western , Reproducibility of Results , Rats, Sprague-Dawley , Streptozocin , Microscopy, Electron, Transmission , Diabetes Mellitus, Experimental/metabolism , Hemodynamics/drug effects , Antioxidants/pharmacology
10.
Med. infant ; 26(2): 189-196, Junio 2019. Tab, ilus
Article in Spanish | LILACS | ID: biblio-1021542

ABSTRACT

La Insuficiencia Cardíaca (IC) es un síndrome clínico que epresenta una de las mayores causas de mobi-mortalidad en pacientes pediátricos. Refleja la incapacidad del corazón para satisfacer las necesidades metabólicas del organismo, incluido el crecimiento y el ejercicio. En el niño la causa más frecuente es la cardiopatía congénita. Otras causas las miocardiopatía, las miocarditis, las arritmias y las causas no cardíacas como: insuficiencia renal, hipertensión arterial, enfermedades pulmonares crónicas, anemia, sepsis, hiper e hipotiroidismo, cardiotoxicidad, etc. Clásicamente el tratamiento estaba dirigido a mejorar la contractilidad y evitar la retención hidrosalina con digital y diuréticos. En la actualidad, dado a la mejor comprensión del mecanismo fisiopatológico, en los últimos años, el tratamiento se centra en el control de los sistemas renina-angiotensina (SRAA) y nervioso simpático. En los casos de IC descompensada que presentan síndrome de bajo gasto cardíaco que no responde a la terapia médica, previo al trasplante cardíaco, está indicado el soporte mecánico (AU)


Heart failure (HF) reflects the inability of the heart to meet the metabolic needs of the body, including growth and exercise. In the child, the most common cause is congenital heart disease. Other causes are cardiomyopathy, myocarditis, arrhythmias, and non-cardiac causes, such as renal failure, high blood pressure, chronic pulmonary diseases, anemia, sepsis, hyper- and hypothyroidism, cardiotoxicity. Classically, the treatment aimed at improving contractility and avoiding salt and fluid retention using digitalis and diuretics. Given the current better understanding of the pathophysiological mechanism, over the past years treatment has focused on the control of renin-angiotensin (RAAS) and sympathetic nervous systems. In cases of decompensated HF with low cardiac output syndrome not responding to medical therapy, prior to cardiac transplantation mechanical support is indicated (AU)


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Heart Failure/etiology , Heart Failure/physiopathology , Heart Failure/drug therapy , Heart Failure/therapy , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Cardiotonic Agents/therapeutic use , Heart-Assist Devices , Adrenergic beta-Agonists/therapeutic use , Diuretics/therapeutic use
11.
Int. j. cardiovasc. sci. (Impr.) ; 32(3): 207-216, May-June 2019. graf
Article in English | LILACS | ID: biblio-1002224

ABSTRACT

Curcuma longa has biological effects. Its cardiovascular activities are yet to be scientifically studied. Objectives: To investigate the vasorelaxant effects of the aqueous extract of Curcuma longa (AECL). Methods: Aortic annuli of normotensive rats, with or without endothelium, were set up in a data storage system with nutrient solution in recipients, with scientifically recommended temperature, aeration and tension. Over contraction by Phenylephrine, the AECL (1, 3, 10, 30, 100, 300 and 1000 µg/mL) was incubated before and after incubation with atropine or L-name or indomethacin. An AECL concentration-response curve was also built over contractions caused by elevation of extracellular K+. Data were significant when p < 0.05, with GraphPad Prism 6.0 software resolutions. Results: The AECL induced 100% vasorelaxation also in the endothelium-free annuli. The part of the endothelium-dependent effect had EC50 = 4.32 ± 0.05 µg/mL. With inhibition of NO production, the EC50 increased to 126.50 ± 2.35 µg/mL; after inhibition of prostacyclin production, to 124.6 ± 0.05 µg/mL; and after muscarinic blockade, to 437.10 ± 0.2 µg/mL. Opening of K+ channels (relaxation of 56.98%) and VOCC blockade (relaxation of 31.56%) were evident. Conclusion: AECL induced significant vasorelaxation, being more significant in the presence of endothelium. The muscarinic pathway seems to be the main one involved in this effect, followed by the NO production and prostacyclin pathways. The activity in K+ channels by AECL was more significant than its VOCC blockade. The use of other models and tools to study action mechanisms will be important and elucidating


Subject(s)
Animals , Rats , Aorta , Phenylephrine , Curcuma/adverse effects , Rats , Vasodilator Agents/therapeutic use , Cardiotonic Agents , Statistical Analysis , Analysis of Variance , Receptors, Muscarinic , Models, Animal , Crocus , Hypertension , Antioxidants
12.
Arq. bras. cardiol ; 112(5): 573-576, May 2019. tab, graf
Article in English | LILACS | ID: biblio-1038537

ABSTRACT

Abstract Selected clinically stable patients with heart failure (HF) who require prolonged intravenous inotropic therapy may benefit from its continuity out of the intensive care unit (ICU). We aimed to report on the initial experience and safety of a structured protocol for inotropic therapy in non-intensive care units in 28 consecutive patients hospitalized with HF that were discharged from ICU. The utilization of low to moderate inotropic doses oriented by a safety-focused process of care may reconfigure their role as a transition therapy while awaiting definitive advanced therapies and enable early ICU discharge.


Resumo Pacientes selecionados com insuficiência cardíaca (IC), clinicamente estáveis que necessitam de terapia inotrópica intravenosa prolongada podem se beneficiar de sua continuidade fora da unidade de terapia intensiva (UTI). Nosso objetivo foi relatar a experiência inicial e a segurança de um protocolo estruturado para terapia inotrópica em unidades de terapia não-intensiva em 28 pacientes consecutivos hospitalizados com IC que receberam alta da UTI. A utilização de doses inotrópicas baixas a moderadas, orientadas por um processo de cuidado focado na segurança, pode reconfigurar seu papel como terapia de transição enquanto aguarda terapias avançadas definitivas e permite a alta precoce da UTI.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Cardiotonic Agents/administration & dosage , Milrinone/administration & dosage , Critical Care/methods , Dobutamine/administration & dosage , Heart Failure/drug therapy , Patient Discharge , Clinical Protocols , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Critical Care/standards
13.
Rev. Assoc. Med. Bras. (1992) ; 65(4): 524-529, Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1003061

ABSTRACT

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.


Subject(s)
Humans , Cardiomyopathy, Dilated/drug therapy , Cardiotonic Agents/therapeutic use , Simendan/therapeutic use , Heart Failure/drug therapy , Brazil , Cardiomyopathy, Dilated/mortality , Reproducibility of Results , Risk Factors , Treatment Outcome , Clinical Decision-Making , Heart Failure/mortality
14.
Article in Chinese | WPRIM | ID: wpr-773153

ABSTRACT

This study is aimed to investigate the intervention effect and possible mechanism of ophiopogonin D( OPD) in protecting cardiomyocytes against ophiopogonin D'( OPD')-induced injury,and provide reference for further research on toxicity difference of saponins from ophiopogonins. CCK-8 assay was used to evaluate the effect of OPD and OPD' on cell viability. The effect of OPD on OPD'-induced cell apoptosis was measured by flow cytometry. Morphologies of endoplasmic reticulum were observed by endoplasmic reticulum fluorescent probe. PERK,ATF-4,Bip and CHOP mRNA levels were detected by Real-time quantitative polymerase chain reaction( PCR) analysis. ATF-4,phosphorylated PERK and e IF2α protein levels were detected by Western blot assay. RESULTS:: showed that treatment with OPD'( 6 μmol·L-1) significantly increased the rate of apoptosis; expressions of endoplasmic reticulum stress related genes were increased. The morphology of the endoplasmic reticulum was changed. In addition,different concentrations of OPD could partially reverse the myocardial cell injury caused by OPD'. The experimental results showed that OPD'-induced myocardial toxicity may be associated with the endoplasmic reticulum stress,and OPD may modulate the expression of CYP2 J3 to relieve the endoplasmic reticulum stress caused by OPD'.


Subject(s)
Apoptosis , Cardiotonic Agents , Pharmacology , Cells, Cultured , Endoplasmic Reticulum Stress , Humans , Myocytes, Cardiac , Saponins , Pharmacology , Spirostans , Pharmacology
15.
Cad. Saúde Pública (Online) ; 35(9): e00191518, 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1039419

ABSTRACT

Resumo: O câncer em indivíduos de 0 a 19 anos é considerado raro, quando comparado à incidência em faixas etárias maiores, sendo estimado entre 2% e 3% de todos os tumores malignos registrados no Brasil. O uso de antraciclinas está frequentemente associado ao aparecimento de cardiotoxicidade e faz parte de aproximadamente 60% dos protocolos terapêuticos em oncologia pediátrica. Dentre as estratégias existentes para a prevenção de cardiotoxicidade, o dexrazoxano obteve resultados favoráveis pautados em desfechos intermediários (marcadores bioquímicos e medidas ecocardiográficas). Foi desenvolvida, neste trabalho, uma avaliação de custo-efetividade que compare o uso do dexrazoxano em diferentes populações, além de uma avaliação do impacto orçamentário causado pela possível incorporação da tecnologia. Foi utilizado o horizonte temporal de toda a vida do paciente e a perspectiva de análise do Sistema Único de Saúde. Uma análise de impacto orçamentário para cada tecnologia também foi construída. Após uma busca na literatura, foi desenvolvido um modelo de Markov capaz de comparar o uso do dexrazoxano em seis perfis de pacientes com risco de desenvolver cardiotoxicidade. Usar o medicamento nas crianças menores de cinco anos de idade se mostrou a alternativa mais custo-efetiva (razão de custo-efetividade incremental - RCEI de R$ 6.156,96), seguida de usar em todos os pacientes (RCEI de R$ 58.968,70). Caso o preço diminua a um valor menor que R$ 250,00 por frasco, a alternativa de usar em todas as crianças se torna a mais custo-efetiva. O impacto orçamentário ao final de cinco anos foi de R$ 30.622.404,81 para uso apenas nas crianças menores de cinco anos. Usar a tecnologia em todas as crianças produziria um impacto incremental de R$ 94.352.898,77.


Abstract: Cancer in individuals 0 to 19 years of age is considered rare when compared to incidence in older age brackets, and is estimated at 2% to 3% of all malignant tumors recorded in Brazil. The use of anthracyclines is frequently associated with cardiotoxicity, and these drugs are part of approximately 60% of treatment protocols in pediatric oncology. Among the existing strategies for the prevention of cardiotoxicity, dexrazoxane obtained favorable results based on intermediate outcomes (biochemical markers and echocardiographic parameters). This study was based on a cost-effectiveness assessment comparing the use of dexrazoxane in different populations, besides an assessment of the budget impact from the technology's potential incorporation. The patient's lifetime was used as the timeline, and the analysis was performed from the perspective of the Brazilian Unified National Health System (SUS). A budget impact analysis was also performed for each technology. After a literature search, a Markov model was developed, capable of comparing the use of dexrazoxane in six profiles of patients at risk of developing cardiotoxicity. Use of the drug in children under 5 years of age proved to be the most cost-effective alternative (incremental cost effectiveness ratio - ICER of BRL 6,156.96), followed by use in all patients (ICER of BRL 58,968.70). If the price decreased to less than BRL 250.00 per vial, the alternative of using the drug in all children would become the most cost-effective. The budget impact at 5 years was BRL 30,622,404.81 for use only in children under 5 years of age. Using the technology in all the children could produce an incremental impact of BRL 94,352,898.77.


Resumen: El cáncer en individuos de 0 a 19 años está considerado raro, cuando se compara la incidencia en franjas etarias mayores, estimándose entre 2% y 3% de todos los tumores malignos registrados en Brasil. El uso antraciclinas está frecuentemente asociado a la aparición de cardiotoxicidad y forma parte de aproximadamente un 60% de los protocolos terapéuticos en oncología pediátrica. Entre las estrategias existentes para la prevención de cardiotoxicidad, el dexrazoxano obtuvo resultados favorables pautados en desenlaces intermedios (marcadores bioquímicos y medidas ecocardiográficas). Se desarrolló en este trabajo, una evaluación de costo efectividad que compare el uso del dexrazoxano en diferentes poblaciones, además de una evaluación del impacto presupuestario causado por la posible incorporación de la tecnología. Se utilizó el horizonte temporal de toda la vida del paciente y la perspectiva de análisis del SUS. También se realizó un análisis del impacto presupuestario para cada tecnología. Tras una búsqueda en la literatura, se desarrolló un modelo de Markov capaz de comparar el uso del dexrazoxano en 6 perfiles de pacientes con riesgo de desarrollar cardiotoxicidad. Usar el medicamento en los niños menores de 5 años de edad se mostró la alternativa más costo-efectiva (relación costo-efectividad incremental - RCEI de BRL 6.156,96), seguido de usarlo en todos los pacientes (RCEI de BRL 58.968,7). En caso de que el precio disminuya a un valor inferior a BRL 250,00 por frasco, la alternativa de usarlo en todos los niños se convierte en la más costo-efectiva. El impacto presupuestario tras 5 años fue de BRL 30.622.404,81 para su uso exclusivo en niños menores de 5 años. Usar esta tecnología en todos los niños, tendría un impacto presupuestario incrementándolo hasta los BRL 94.352.898,77.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Cardiotonic Agents/economics , Anthracyclines/adverse effects , Dexrazoxane/economics , Heart/drug effects , Heart Failure/prevention & control , Neoplasms/drug therapy , Cardiotonic Agents/therapeutic use , Age Factors , Cost-Benefit Analysis , Dexrazoxane/therapeutic use , Cardiotoxicity/prevention & control , Heart Failure/chemically induced
16.
Braz. arch. biol. technol ; 62: e19190055, 2019. graf
Article in English | LILACS | ID: biblio-1055417

ABSTRACT

Abstract This study aimed to investigate the cardioprotection of rosuvastatin pre-conditioning (R-Pre) in a rat model of myocardial ischemia / reperfusion (I/R). Male SD rats were assigned into three groups: sham group, I/R group and R-Pre group. Rats in I/R group and R-Pre group received ischemia for 30 min and reperfusion for 2 h. In R-Pre group, rats received intragastrical administration with rosuvastatin at 5 mg/kg once daily for 1 week. After 2-h reperfusion, the cardiac function was detected by ultrasonography; the blood was collected for biochemical analysis; the heart was collected for the TUNEL staining and immunohistochemistry for Bcl-2 and Bax. Our results showed rosuvastatin pre-conditioning for 1 week could significantly reduce the infarct ratio and improve the cardiac function after myocardial I/R injury, in which attenuation of oxidative stress and cell apoptosis played an important role. Our study provides evidence on the cardioprotection of rosuvastatin pre-conditioning and highlight the use of rosuvastatin before cardiopulmonary bypass.


Subject(s)
Animals , Rats , Myocardial Reperfusion , Ischemia/therapy , Cardiotonic Agents/administration & dosage , Apoptosis , Oxidative Stress , Models, Animal , Rosuvastatin Calcium/administration & dosage
17.
Acta cir. bras ; 34(5): e201900505, 2019. graf
Article in English | LILACS | ID: biblio-1010872

ABSTRACT

Abstract Purpose: To evaluate the cardioprotective response of the pharmacological modulation of β-adrenergic receptors (β-AR) in animal model of cardiac ischemia and reperfusion (CIR), in spontaneously hypertensive (SHR) and normotensive (NWR) rats. Methods: CIR was induced by the occlusion of left anterior descendent coronary artery (10 min) and reperfusion (75 min). The SHR was treated with β-AR antagonist atenolol (AT, 10 mg/kg, IV) 5 min before CIR, and NWR were treated with β-AR agonist isoproterenol (ISO, 0.5 mg/kg, IV) 5 min before CIR. Results: The treatment with AT increased the incidence of VA, AVB and LET in SHR, suggesting that spontaneous cardioprotection in hypertensive animals was abolished by blockade of β-AR. In contrast, the treatment with ISO significantly reduced the incidence of ventricular arrhythmia, atrioventricular blockade and lethality in NWR (30%, 20% and 20%, respectively), suggesting that the activation of β-AR stimulate cardioprotection in normotensive animals. Serum CK-MB were higher in SHR/CIR and NWR/CIR compared to respective SHAM group (not altered by treatment with AT or ISO). Conclusion: The pharmacological modulation of β-AR could be a new cardioprotective strategy for the therapy of myocardial dysfunctions induced by CIR related to cardiac surgery and cardiovascular diseases.


Subject(s)
Animals , Male , Atenolol/pharmacology , Cardiotonic Agents/pharmacology , Myocardial Reperfusion Injury/drug therapy , Receptors, Adrenergic, beta/drug effects , Adrenergic beta-Agonists/pharmacology , Adrenergic beta-1 Receptor Antagonists/pharmacology , Isoproterenol/pharmacology , Rats, Inbred SHR , Time Factors , Blood Pressure/drug effects , Biomarkers/blood , Myocardial Reperfusion Injury/physiopathology , Myocardial Reperfusion Injury/blood , Reproducibility of Results , Treatment Outcome , Creatine Kinase, MB Form/blood , Heart Function Tests
18.
Med. infant ; 25(4): 291-294, diciembre 2018. tab, ilus
Article in Spanish | LILACS | ID: biblio-969891

ABSTRACT

Introducción: El tratamiento de la insuficiencia cardiaca ha incorporado drogas inotrópicas de muy alto costo, como el levosimendan (LEVO). La evaluación de la respuesta a estas drogas en pediatría ofrece dificultades por lo que la medición de biomarcadores como la prohormona N-Terminal Péptido Natriurético Cerebral (NT-ProBNP) podrían ser de utilidad. Objetivo: describir la variación del NT-ProBNP y su correlación con parámetros ecocardiográficos en respuesta a la administración de levosimendan en pacientes pediátricos con insuficiencia cardiaca. Diseño: estudio descriptivo, observacional y prospectivo, sin intervención. Pacientes y métodos: se incluyeron pacientes con insuficiencia cardiaca de 0 a 18 años internados en terapia intensiva a los cuales se les pudo realizar dosaje de NT ProBNP pre LEVO. Se midió dicho péptido al 1°, 3° y 5° día post LEVO. Con cada determinación se realizó ecocardiograma doppler. Resultados: Se enrolaron 15 pacientes, mediana de edad 188,5 días (IQR 25-75: 56-475); de peso 5,475 kg (IQR 25-75: 2.8-7.5). El 80% fueron pacientes con reparación quirúrgica de cardiopatías congénitas, 13.3% con ventrículo único. La mediana de valor de NT ProBNPantes de la administración de LEVO fue 8924.5 pg./ml (IQR 25-75: 4096-20419,75). El 80% de la población presentó descenso en el valor de pro BNP post LEVO y en 10 (66.6%) el descenso fue mayor o igual al 30%. La evaluación global de la función miocárdica no presentó diferencias antes y después del LEVO. Conclusiones: El 66% de los pacientes presentó una disminución de al menos un 30% en los valores de NT ProBNP luego de la administración de levosimendan


Introduction: Very high-cost inotropic drugs, such as levosimendan (LEVO), have been incorporated in the treatment of heart failure. Evaluation of the response to these drugs in children is difficult and measurement of biomarkers such as the prohormone N-terminal pro b-type natriuretic peptide (NT-proBNP) may be of use. Objective: To describe variation of NT-ProBNP and its correlation with echocardiographic parameters in response to the administration of LEVO in pediatric patients with heart failure. Design: A prospective, descriptive, observational, non-interventional study. Patients and methods: Patients between 0 and 18 years of age with heart failure admitted to the intensive care unit in whom pre-LEVO NT-ProBNP levels could be measured were included. NT-ProBNP levels were measured at day 1, 3, and 5 post LEVO. At each measurement, a Doppler echocardiogram was performed. Results: 15 patients with a median age of 188.5 days (IQR 25-75: 56-475) and a weight of 5.475 kg (IQR 25-75: 2.8-7.5) were enrolled. Of the patients, 80% had undergone surgery for congenital heart defects, 13.3% with a single ventricle. Median NT-ProBNP levels before LEVO administration were 8924.5 pg./ml (IQR 25-75: 4096-20419.75). Overall, 80% of the patients had a decrease of post-LEVO NT-ProBNP levels and in 10 (66.6%) the decrease was greater than or equal to 30%. Overall evaluation of myocardial function did not show differences before and after LEVO administration. Conclusions: 66% of the patients presented with a decrease of at least 30% of NT-ProBNP levels after LEVO administration


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Biomarkers/blood , Cardiotonic Agents/therapeutic use , Natriuretic Peptide, Brain/blood , Heart Defects, Congenital/drug therapy , Heart Failure/drug therapy , Echocardiography, Doppler/drug effects , Prospective Studies , Observational Study
19.
Rev. colomb. cardiol ; 25(5): 344-352, sep.-oct. 2018. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1042776

ABSTRACT

Resumen La falla cardiaca en una patología poco reconocida en la edad pediátrica y tiene una alta tasa de mortalidad al no ser diagnosticada en forma temprana. Se hace una revisión del diagnóstico, la estratificación y el manejo actual de la falla cardiaca en niños y se mencionan las nuevas terapias actualmente en investigación.


Abstract Heart failure is a little known condition at paediatric age, and has a high mortality rate on not being diagnosed early. A review is presented on its diagnosis, stratification, and current management of heart failure in children, as well the new therapies currently under investigation.


Subject(s)
Humans , Male , Female , Infant, Newborn , Cardiotonic Agents , Heart Failure , Natriuretic Peptide, Brain , Cardiomyopathies
20.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 28(4): 434-439, out.-dez. 2018. ilus, graf
Article in English, Portuguese | LILACS | ID: biblio-970628

ABSTRACT

A insuficiência cardíaca aguda é a principal causa de hospitalização em pacientes acima de 65 anos, além de possuir altos índices de mortalidade hospitalar. Na sua abordagem terapêutica é mandatório um diagnóstico rápido e pronta caracterização do perfil hemodinâmico, baseando-se nos sinais clínicos de congestão e baixo débito cardíaco, para que possamos instituir a terapêutica com drogas endovenosas para alívio rápido dos sintomas, restabelecer a perfusão adequada dos órgãos e reduzir o risco de morte. As drogas a serem administradas de forma isolada ou em combinação são representadas pela furosemida endovenosa em infusão intermitente e contínua, dependendo do grau de congestão pulmonar e/ou sistêmica, as drogas vasodilatadoras e os agentes inotrópicos. As drogas vasodilatadoras, como o nitroprussiato de sódio e a nitroglicerina via endovenosa são, frequentemente, adicionadas aos diuréticos para o tratamento da insuficiência cardíaca aguda com perfil hemodinâmico B, promovendo estabilidade hemodinâmica mais rápida e pronto alívio da dispneia. O nitroprussiato de sódio é preferível nos pacientes com IC perfil B com níveis elevados de resistência vascular periférica e grave congestão pulmonar. Já a nitroglicerina é preferível nos pacientes com cardiopatia isquêmica ou com insuficiência coronariana aguda associada à insuficiência cardíaca. Os agentes inotrópicos positivos estão indicados nos pacientes com IC aguda e evidências de baixo débito cardíaco (perfil hemodinâmico C), a fim de garantir a melhora da perfusão tissular mediante aumento do débito cardíaco, principalmente, nos pacientes hipotensos e com piora da função renal. A associação de inotrópicos com vasodilatadores deve ser considerada quando existe a combinação de baixo débito cardíaco e aumento significativo de resistência vascular pulmonar e ou sistêmica


Acute heart failure is the leading cause of hospitalization in patients over 65 years of age and is accompanied by high hospital mortality rates. In its therapeutic approach, rapid diagnosis and prompt characterization of the hemodynamic profile based on clinical signs of congestion and low cardiac output are mandatory so that we can provide intravenous drug therapy for rapid symptom relief to restore adequate organ perfusion and reduce the risk of death. Drugs to be used alone or in combination are represented by intravenous furosemide in intermittent infusion and continue to depend on the degree of pulmonary and/or systemic congestion, vasodilator drugs, and inotropic agents. Vasodilator drugs, such as sodium nitroprusside and intravenous nitroglycerin, are often added to diuretics for the treatment of acute cardiac insufficiency with hemodynamic profile B, promoting faster hemodynamic stability and prompt relief of dyspnea. Sodium nitroprusside is preferable in patients with hemodynamic profile B with high peripheral vascular resistance and severe pulmonary congestion. Nitroglycerin is preferable in patients with ischemic heart disease or acute coronary insufficiency associated with heart failure (HF). Positive inotropic agents are indicated in patients with acute HF and evidence of low cardiac output (hemodynamic profile C) to ensure improvement in tissue perfusion by increasing cardiac output, especially in patients with hypotension and worsening renal function. The association of inotropes and vasodilators should be considered when there is a combination of low cardiac output and significant increase in pulmonary and/or systemic vascular resistance


Subject(s)
Humans , Male , Female , Vasodilator Agents/therapeutic use , Acute Disease , Heart Failure/therapy , Therapeutics , Cardiotonic Agents , Cardiovascular Diseases , Diuretics/therapeutic use , Dobutamine/therapeutic use , Hemodynamics
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