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1.
Braz. j. otorhinolaryngol. (Impr.) ; 87(4): 457-461, July-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1285715

ABSTRACT

Abstract Introduction Prognosis of sudden sensorineural hearing loss may be predicted using several parameters of laboratory blood analysis. Objective To identify and investigate the most significant indicator parameters related to the poor prognosis of sudden sensorineural hearing loss. Methods Eighty-eight patients were included, and three groups were constituted: non-recovery group with14 patients, recovery group with 33 patients and control group with 41 individuals. We compared fibrinogen-to-albumin ratio, C-reactive protein-to-albumin ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, white blood cell and hemoglobin of the groups. Then, we investigated the most significant indicator parameters related to the poor prognosis of sudden hearing loss. Results The mean hemoglobin, mean platelet-lymphocyte ratio and median white blood cell values did not significantly differ among three groups (p = 0.36, p = 0.86 and p = 0.79, respectively). A significant difference of median fibrinogen-albumin ratio, C-reactive protein-albumin ratio, neutrophil-to-lymphocyte ratio was evident among three groups (p < 0.001, p = 0.003 and p = 0.002, respectively). Median fibrinogen-albumin ratio, C-reactive protein-albumin ratio and neutrophil-to-lymphocyte ratio values were significantly greater in the non-recovery group, compared with the controls (p < 0.001, p = 0.003 and p = 0.005, respectively). Median fibrinogen-to-albumin ratio, C-reactive protein-to-albumin ratio and neutrophil-to-lymphocyte ratio were significantly greater in the recovery group, compared with the controls (p < 0.001, p = 0.013 and p = 0.005, respectively). Moreover, the median fibrinogen-albumin ratio was significantly greater in the non-recovery group compared with the recovery group (p = 0.017). However, no statistically significant difference of median C-reactive protein-albumin ratio, neutrophil-to-lymphocyte was evident between the non-recovery and recovery groups (p = 0.15). Conclusion Increased levels of fibrinogen-albumin ratio may be predictive for poor prognosis in patients with sudden sensorineural hearing loss.


Resumo Introdução O prognóstico de perda auditiva neurossensorial súbita pode ser previsto com vários parâmetros da análise laboratorial do sangue. Objetivo Identificar e investigar os parâmetros indicadores mais significativos relacionados ao mau prognóstico da perda auditiva neurossensorial súbita. Método Foram incluídos 88 pacientes e três grupos foram constituídos: grupo não recuperado, com14 pacientes; grupo com recuperação, 33 pacientes, e grupo controle com 41 indivíduos. Foram comparadas a relação fibrinogênio/albumina, proteína C-reativa/albumina, relação neutrófilos/linfócitos, relação plaquetas/linfócitos, glóbulos brancos e hemoglobina dos grupos. Em seguida, investigamos os parâmetros indicadores mais significativos relacionados ao prognóstico ruim da perda súbita de audição. Resultados A média de hemoglobina, média da relação plaquetas/linfócitos e mediana dos valores de glóbulos brancos não diferiram significativamente entre os três grupos (p = 0,36, p = 0,86 e p = 0,79, respectivamente). Uma diferença significante da média da relação fibrinogênio/albumina, proteína C-reativa/albumina e neutrófilos/linfócitos foi evidente entre os três grupos (p < 0,001, p = 0,003 e p = 0,002, respectivamente). Os valores da mediana da relação fibrinogênio/albumina, proteína C-reativa/albumina e relação neutrófilos/linfócitos foram significantemente maiores no grupo sem recuperação, em comparação com os controles (p < 0,001, p = 0,003 e p = 0,005, respectivamente). As medianas da relação fibrinogênio/albumina, relação proteína C-reativa/albumina e relação neutrófilos/linfócitos foram significantemente maiores no grupo com recuperação, em comparação com os controles (p < 0,001, p = 0,013 e p = 0,005, respectivamente). Além disso, a mediana da relação fibrinogênio/albumina foi significantemente maior no grupo não recuperado comparado ao grupo com recuperação (p = 0,017). No entanto, não houve diferença estatisticamente significante da mediana da relação proteína-C reativa/albumina e relação neutrófilos/linfócitos entre os grupos sem recuperação e com recuperação (p = 0,15). Conclusão Níveis elevados de relação fibrinogênio/albumina podem ser preditores de mau prognóstico em pacientes com perda auditiva neurossensorial súbita.


Subject(s)
Humans , Hearing Loss, Sudden , Hearing Loss, Sensorineural , Prognosis , C-Reactive Protein/analysis , Fibrinogen/analysis , Retrospective Studies , Albumins
2.
Rev. bras. ciênc. vet ; 28(1): 61-66, jan./mar. 2021. il.
Article in English | LILACS, VETINDEX | ID: biblio-1368827

ABSTRACT

Plasma levels of hematocrit, total plasma protein, fibrinogen, creatine phosphokinase, aspartate transferase, and lactate were analyzed in blood samples of 85 Crioula breed foals, from birth to two years of age. The animals were divided into age groups: G1 (up to 15 days of age; n=70), G2 (from 16 days to one month of age; n=67), G3 (between one and three months of age; n=75), G4 (between three and six months of age; n=64), G5 (between six and nine months of age; n=59), G6 (between nine and 18 months of age; n=39), and G7 (between 18 months and two years of age; n=17). These groups were statistically analyzed by one-way variance analysis (ANOVA) and Tukey's test. Male and female means were compared by Student's t-test. Hematocrit levels were significantly higher up to 90 days of age and in G7 females. Total plasma proteins increased significantly in groups 3, 4, 6, and 7. The highest fibrinogen levels were found in G1. Yet for creatine phosphokinase, the highest concentrations were detected in G5, whereas those of aspartate aminotransferase in G7. The levels of this enzyme remained similar from 30 days to two years of age. Lactate concentrations were higher in G3. We concluded that the sex of the animal had no significant effect on laboratory test interpretations. By contrast, the age of the animal should be considered since relevant variations were observed with time. Nevertheless, specific tables for each analysis should be consulted for interpretation of results.


Com o propósito de estabelecer valores de hematócrito, proteínas plasmáticas totais, fibrinogênio, creatina quinase , aspartato transferase e lactato em potros da raça Crioula, do nascimento até os dois anos, utilizaram-se amostras sanguíneas de 85 animais, divididos pela estratificação etária: Grupo 1 (G1) Até 15 dias de vida (n=70); grupo 2 (G2), entre 16 dias até um mês (n=67); grupo 3 (G3), entre 1 e 3 meses (n=75); grupo 4 (G4), entre 3 e 6 meses (n=64); grupo 5 (G5), entre 6 e 9 meses (n=59); grupo 6 (G6), entre 9 e 18 meses (n=39); e grupo 7 (G7), entre 18 meses até 2 anos (n=17). Foi realizado estudo estatístico entre os grupos pela análise de variância unidirecional (one-wayANOVA), complementada pelo teste de Tukey. Para comparação das médias entre os sexos utilizou-se o teste t de Student. O hematócrito foi significativamente mais elevado até os 90 dias e nas fêmeas do G7. Para proteínas plasmáticas totais, notou-se aumento significativo nos grupos 3, 4, 6 e 7. Os valores de fibrinogênio foram maiores no G1. A CK apresentou maior concentração no G5 e a AST no G7. A AST assumiu valores semelhantes dos 30 dias até os 2 anos. A concentração de lactato foi mais elevada no G3. Conclui-se que na interpretação dos exames laboratoriais de potros da raça crioula, o gênero não interfere significativamente nos resultados, porém a idade deve ser considerada devido à ocorrência de variações relevantes. Recomenda-se que para interpretação sejam consultadas tabelas específicas para cada análise.


Subject(s)
Animals , Blood Chemical Analysis/veterinary , Blood Specimen Collection/veterinary , Reference Standards/methods , Horses/blood , Fibrinogen/analysis , Blood Proteins/analysis , Creatine Kinase/analysis , Laboratory Test/analysis , Hematocrit/veterinary , Hematologic Tests/veterinary
3.
Rev. bras. anestesiol ; 70(6): 635-641, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1155763

ABSTRACT

Abstract Background and objectives: Sugammadex is an alternative pharmacological drug capable of reversing neuromuscular blockades without the limitations that are presented by anticholinesterase drugs. Coagulation disorders that are related to treatment with sugammadex were reported. The exact mechanism of the effects on coagulation are not fully understood. The objective of this research is to evaluate the effects of rocuronium, sugammadex and the rocuronium-sugammadex complex on coagulation in an experimental model in rats. Methods: This is an experimental randomized animal study. Wistar rats were randomly assigned into the following groups: the Control Group; the Ssal Group - 0.5 mL of intravenous saline; the Sugammadex Group - intravenous sugammadex (100 mg kg−1); and the Rocuronium-Sugammadex Group - intravenous solution with rocuronium (3.75 mg kg−1) and sugammadex (100 mg kg−1). Anesthesia was performed by using isoflurane with controlled ventilation. Coagulation factors were measured 10 minutes after the end of the preoperative preparation and 30 minutes after the administration of the drugs in accordance with the chosen groups. Results: Platelet counts, prothrombin times, and activated partial thromboplastin times were similar between the groups and between the moments within each group. There were reductions in the plasma fibrinogen levels between sample times 1 and 2 in the Rocuronium-Sugammadex group (p = 0.035). Conclusions: The rocuronium-sugammadex complex promoted reductions in plasma fibrinogen counts, although the levels were still within normal limits.


Resumo Introdução e objetivos: O sugamadex é uma substância farmacológica alternativa capaz de reverter o bloqueio neuromuscular sem as limitações apresentadas pelos anticolinesterásicos. Entretanto, há relatos de transtornos de coagulação relacionados ao tratamento com sugamadex sem que mecanismos exatos de seus efeitos sobre a coagulação sejam totalmente compreendidos. O objetivo da presente pesquisa foi avaliar os efeitos do rocurônio, sugamadex e do complexo rocurônio-sugamadex sobre a coagulação em um modelo experimental com ratos. Métodos: Este é um estudo randomizado experimental animal. Ratos Wistar foram aleatoriamente designados aos seguintes grupos: grupo controle; Grupo Ssal - 0,5 mL de solução salina intravenosa; Grupo sugamadex - sugamadex intravenoso (100 mg.kg-1); e Grupo rocurônio-sugamadex - solução intravenosa com rocurônio (3,75 mg.kg-1) e sugamadex (100 mg.kg-1). A anestesia foi realizada utilizando-se isoflurano com ventilação controlada. Os fatores de coagulação foram medidos 10 minutos após o final do preparo pré-operatório e 30 minutos após a administração de drogas de acordo com os grupos escolhidos. Resultados: Contagem de plaquetas, tempo de protrombina e tempo de tromboplastina parcial ativada foram semelhantes entre os grupos e entre os momentos dentro de cada grupo. Houve redução nos níveis de fibrinogênio plasmático entre os tempos 1 e 2 no grupo rocurônio-sugamadex (p = 0,035). Conclusões: O complexo rocurônio-sugamadex promoveu reduções na contagem de fibrinogênio plasmático, apesar de os níveis continuarem dentro dos limites normais.


Subject(s)
Animals , Rats , Blood Coagulation/drug effects , Neuromuscular Nondepolarizing Agents/pharmacology , Neuromuscular Blockade , Sugammadex/pharmacology , Rocuronium/pharmacology , Partial Thromboplastin Time , Platelet Count , Prothrombin Time , Fibrinogen/analysis , Random Allocation , Rats, Wistar , Neuromuscular Nondepolarizing Agents/administration & dosage , Anesthetics, Inhalation , Drug Combinations , Sugammadex/administration & dosage , Rocuronium/administration & dosage , Isoflurane , Anesthesia/methods
4.
Rev. Assoc. Med. Bras. (1992) ; 66(6): 842-848, June 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136295

ABSTRACT

SUMMARY INTRODUCTION Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly described virus responsible for the outbreak of the coronavirus disease 2019 (Covid-19), named by the World Health Organization (WHO) in February/2020. Patients with Covid-19 have an incidence of acute respiratory distress syndrome (ARDS) of 15.9-29% and sepsis is observed in all deceased patients. Moreover, disseminated intravascular coagulation (DIC) is one of the major underlying causes of death among these patients. In patients with DIC, there is a decrease in fibrinogen and an increase in D-dimer levels. Some studies have shown that fibrinogen and one of its end products, D-dimer, might have a predictive value for mortality in patients with non-Covid sepsis secondary to complications of DIC. Therefore, anticoagulation, considering its mortality benefits in cases of non-Covid sepsis, may also have an important role in the treatment of Covid-19. METHODS We reviewed the literature of all studies published by April 2020 on patients infected with Covid-19. Our review was limited to D-dimer and fibrinogen changes and anticoagulation recommendations. RESULTS Anticoagulation therapy can be started following the DIC diagnosis in Covid-19 patients despite the bleeding risks. In addition, the current evidence suggests a routine use of anticoagulation, particularly in patients with higher D-dimer levels (> 3.0 μg/mL). CONCLUSION Covid-19 is a systemic, hypercoagulable disease requiring more studies concerning treatment. Aanticoagulation is still an issue to be studied, but D-dimer rise and disease severity are the indicative factors to start treatment as soon as possible.


RESUMO INTRODUÇÃO O coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2) é o vírus responsável pelo surto recentemente batizado de doença pelo coronavirus 2019 (Covid-19) pela Organização Mundial de Saúde (OMS) em fevereiro/2020. Os doentes com Covid-19 têm uma incidência de síndrome de dificuldade respiratória aguda (SDRA) de 15,9-29% e sepse é observada em todos os pacientes que vêm a óbito. Além disso, a coagulação intravascular disseminada (DIC) é uma das principais causas subjacentes de morte entre esses pacientes. Em pacientes com DIC, ocorre com uma diminuição do fibrinogênio e um aumento dos níveis de dímero D. Alguns estudos mostraram que o fibrinogênio e um dos seus produtos finais, o dímero D, podem ter um valor preditivo para a mortalidade em pacientes com sepse não relacionada à Covid-19 decorrente de complicações da DIC. Portanto, a anticoagulação, considerando seus benefícios quanto à mortalidade na sepse não relacionada à Covid-19, pode também ter um papel importante no tratamento da Covid-19. MÉTODOS Realizamos uma revisão de todos os estudos publicados até abril de 2020 sobre pacientes infectados com Covid-19. A nossa revisão limitou-se a alterações no dímero D, nos fibrinogênios e recomendações de anticoagulantes. RESULTADOS A terapêutica anticoagulante pode ser iniciada após o diagnóstico de DIC em pacientes com Covid-19 apesar dos riscos de hemorragia. Além disso, a evidência atual sugere o uso rotineiro da anticoagulação, principalmente em pacientes com níveis mais elevados de dímero D (> 3, 0 µg/mL). CONCLUSÃO A Covid-19 é uma doença sistêmica e hipercoagulável que requer mais estudos em relação ao tratamento. A anticoagulação ainda é uma questão a ser estudada, mas o aumento de dímeros D e a gravidade da doença são os fatores indicativos para o início do tratamento o mais rápido possível.


Subject(s)
Humans , Pneumonia, Viral/complications , Blood Coagulation Disorders/therapy , Blood Coagulation Disorders/virology , Fibrinogen/analysis , Coronavirus Infections/complications , Coronavirus , Pandemics , Anticoagulants/therapeutic use , Fibrin Fibrinogen Degradation Products/analysis , Biomarkers/analysis , Coronavirus Infections , Betacoronavirus
5.
Clinics ; 75: e993, 2020. tab, graf
Article in English | LILACS | ID: biblio-1089599

ABSTRACT

Many researchers have shown that pretreatment plasma fibrinogen levels are closely correlated with the prognosis of patients with lung cancer (LC). In this study, we thus performed a meta-analysis to systematically assess the prognostic value of pretreatment plasma fibrinogen levels in LC patients. A computerized systematic search in PubMed, EMBASE, Web of Science and China National Knowledge Infrastructure (CNKI) was performed up to March 15, 2018. Studies with available data on the prognostic value of plasma fibrinogen in LC patients were eligible for inclusion. The pooled hazard ratios (HRs) and odd ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the correlation between pretreatment plasma fibrinogen levels and prognosis as well as clinicopathological characteristics. A total of 17 studies with 6,460 LC patients were included in this meta-analysis. A higher pretreatment plasma fibrinogen level was significantly associated with worse overall survival (OS) (HR: 1.57; 95% CI: 1.39-1.77; p=0.001), disease-free survival (DFS) (HR: 1.53; 95% CI: 1.33-1.76; p=0.003), and progression-free survival (PFS) (HR: 3.14; 95% CI: 2.15-4.59; p<0.001). Furthermore, our subgroup and sensitivity analyses demonstrated that the pooled HR for OS was robust and reliable. In addition, we also found that a higher fibrinogen level predicted advanced TNM stage (III-IV) (OR=2.18, 95% CI: 1.79-2.66; p<0.001) and a higher incidence of lymph node metastasis (OR=1.74, 95% CI: 1.44-2.10; p=0.02). Our study suggested that higher pretreatment plasma fibrinogen levels predict worse prognoses in LC patients.


Subject(s)
Humans , Fibrinogen/metabolism , Carcinoma, Non-Small-Cell Lung/blood , Lung Neoplasms/blood , Prognosis , Fibrinogen/analysis , Biomarkers/blood , Survival Analysis , China , Carcinoma, Non-Small-Cell Lung/metabolism , Carcinoma, Non-Small-Cell Lung/mortality , Disease-Free Survival , Progression-Free Survival , Lung Neoplasms/metabolism
6.
J. bras. pneumol ; 44(1): 36-41, Jan.-Feb. 2018. tab, graf
Article in English | LILACS | ID: biblio-893895

ABSTRACT

ABSTRACT Objective: To evaluate the value of soluble urokinase-type plasminogen activator receptor (suPAR) in the diagnosis of acute exacerbation of COPD (AECOPD) and in monitoring treatment response, analyzing the relationship between suPAR and fibrinogen in AECOPD. AECOPD leads to increased airway inflammation, contributing to an exaggerated release of inflammatory mediators. Methods: We recruited 45 patients with AECOPD and 20 healthy control subjects. Medical histories were taken, and all subjects underwent clinical examination, chest X-ray, pulmonary function tests, and blood gas analysis. On day 1 (treatment initiation for the AECOPD patients) and day 14 (end of treatment), blood samples were collected for the determination of serum suPAR and plasma fibrinogen. Results: Serum levels of suPAR were significantly higher in the AECOPD group than in the control group. In the AECOPD patients, there was a significant post-treatment decrease in the mean serum suPAR level. The sensitivity, specificity, and accuracy of suPAR were 95.6%, 80.0%, and 93.0%, respectively. The Global Initiative for Chronic Obstructive Lung Disease stage (i.e., COPD severity) correlated positively and significantly with serum levels of suPAR and plasma levels of fibrinogen. Conclusions: Monitoring the serum suPAR level can be helpful in the evaluation of the COPD treatment response and might be a valuable biomarker for determining the prognosis of AECOPD. Because serum suPAR correlated with plasma fibrinogen, both markers could be predictive of AECOPD.


RESUMO Objetivo: Avaliar o valor do soluble urokinase-type plasminogen activator receptor (suPAR, receptor do ativador de plasminogênio tipo uroquinase solúvel) no diagnóstico de exacerbação aguda da DPOC (EADPOC) e no monitoramento da resposta ao tratamento, analisando-se a relação entre o suPAR e o fibrinogênio na EADPOC. A EADPOC leva ao aumento da inflamação das vias aéreas, contribuindo para a liberação exagerada de mediadores inflamatórios. Métodos: Foram recrutados 45 pacientes com EADPOC e 20 controles saudáveis. Realizou-se anamnese, e todos os indivíduos foram submetidos a exame clínico, radiografia de tórax, provas de função pulmonar e gasometria arterial. No dia 1 (início do tratamento para os pacientes com EADPOC) e no dia 14 (final do tratamento), foram coletadas amostras de sangue para dosagem de suPAR sérico e de fibrinogênio plasmático. Resultados: Os níveis séricos de suPAR foram significativamente maiores no grupo EADPOC do que no grupo controle. Nos pacientes com EADPOC, houve diminuição significativa da média de suPAR sérico após o tratamento. A sensibilidade, a especificidade e a acurácia do suPAR foram, respectivamente, de 95,6%, 80,0% e 93,0%. O estágio da doença segundo a Global Initiative for Chronic Obstructive Lung Disease (isto é, a gravidade da DPOC) apresentou correlação positiva e significativa com os níveis séricos de suPAR e os níveis plasmáticos de fibrinogênio. Conclusões: O monitoramento do suPAR sérico pode ser útil na avaliação da resposta ao tratamento da DPOC e seria um biomarcador valioso para a determinação do prognóstico da EADPOC. Como o suPAR sérico apresentou correlação com o fibrinogênio plasmático, ambos os marcadores poderiam ser preditores da EADPOC.


Subject(s)
Humans , Male , Female , Middle Aged , Fibrinogen/analysis , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/blood , Receptors, Urokinase Plasminogen Activator/blood , Reference Values , Respiratory Function Tests , Time Factors , Blood Gas Analysis , Enzyme-Linked Immunosorbent Assay , Biomarkers/blood , Case-Control Studies , Acute Disease , Sensitivity and Specificity , Treatment Outcome , Pulmonary Disease, Chronic Obstructive/therapy
7.
Arq. bras. med. vet. zootec ; 69(2): 285-292, mar.-abr. 2017. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-833812

ABSTRACT

Serum protein concentrations, including acute phase proteins (APPs), of goats and ewes with naturally acquired Sthaphylococcus aureus mastitis were determined by means of SDS-PAGE electrophoresis to evaluate the relevance of these APPs as biomarkers of the disease in these species. Fifteen healthy goats and 5 goats with naturally acquired staphylococci mastitis, as well as fifteen healthy ewes and 5 ewes with staphylococci mastitis were submitted to daily blood sampling during 7 days. In goats, an increase of 570%, 125%, 621%, and 279% in serum concentrations of ceruloplasmin, fibrinogen, haptoglobin and α1-acid glycoprotein, respectively, was observed. In sheep the increase in serum concentrations of ceruloplasmin, fibrinogen, haptoglobin and α1-acid glycoprotein was of 337%, 90%, 461%, and 225%, respectively. Our results indicate that these APPs have considerable potencial as early and sensible biomarkers of mastitis caused by S. aureus in goats and sheep.(AU)


O proteinograma, incluindo proteínas de fase aguda (PFAs), de cabras e ovelhas com mastite de origem natural causada por Staphylococcus aureus, foi determinado por meio de eletroforese em gel de poliacrilamida contendo dodecil sulfato de sódio (SDS-PAGE) a fim de avaliar a importância destas PFAs como biomarcadores da enfermidade nestas espécies. Amostras de sangue foram colhidas diariamente de cinco cabras e cinco ovelhas com mastite estafilocócica naturalmente adquirida, bem como de quinze cabras e quinzes ovelhas saudáveis durante 6 dias consecutivos. Nas fêmeas caprinas, foi verificado aumento dos teores séricos de ceruloplasmina (570%), fibrinogênio (125%), haptoglobina (621%), e α1-glicoproteína ácida (279%). Nas fêmeas ovinas as concentrações de ceruloplasmina, fibrinogênio, haptoglobina e α1-glicoproteína ácida elevaram-se em 337%, 90,9%, 461% e 225%, respectivamente. Os resultados permitem inferir que estas PFAs são marcadores sensíveis e precoces de mastite causada por S. aureus em cabras e ovelhas.(AU)


Subject(s)
Animals , Female , Acute-Phase Proteins/analysis , Anti-Infective Agents/chemistry , Goats/virology , Mastitis/veterinary , Sheep/virology , Staphylococcus aureus , Ceruloplasmin/analysis , Electrophoresis, Polyacrylamide Gel/veterinary , Fibrinogen/analysis , Haptoglobins/analysis , Orosomucoid/analysis
9.
Arq. bras. cardiol ; 106(6): 457-463, tab, graf
Article in English | LILACS | ID: lil-787317

ABSTRACT

Abstract Background: Excessive weight is a cardiovascular risk factor since it generates a chronic inflammatory process that aggravates the endothelial function. Objective: To evaluate the endothelial function in individuals with excess weight and mild dyslipidemia using brachial artery flow-mediated dilation (BAFMD), and the association of endothelial function with anthropometric and biochemical variables. Methods: Cross-sectional study that included 74 individuals and evaluated anthropometric variables (body mass index [BMI], waist-hip ratio [WHR], waist circumference [AC], and percentage of body fat [PBF]), biochemical (blood glucose, insulinemia, ultrasensitive C-reactive protein, fibrinogen, total cholesterol, HDL-cholesterol, triglycerides, and LDL-cholesterol) and endothelial function (BAFMD, evaluated by ultrasound). The statistical analysis was performed with SPSS, version 16.0. To study the association between the variables, we used chi-square, Student's t and Mann-Whitney tests, and Pearson's correlation. Logistic regression analyzed the independent influence of the factors. Values of p < 0.05 were considered significant. Results: The participants had a mean age of 50.8 years, and 57% were female. BMI, WC, WHR, and PBF showed no significant association with BAFMD. The male gender (p = 0.02) and higher serum levels of fibrinogen (p = 0.02) were significantly and independently associated with a BAFMD below 8%. Conclusions: In individuals with excess weight and mild untreated dyslipidemia, male gender and higher levels of fibrinogen were independently associated with worse BAFMD.


Resumo Fundamento: O excesso de peso é um fator de risco cardiovascular, pois gera um processo inflamatório crônico que agrava a função endotelial. Objetivo: Avaliar a função endotelial de indivíduos com excesso de peso e dislipidemia leve através da dilatação da artéria braquial mediada pelo fluxo (DABMF) e sua associação com variáveis antropométricas e bioquímicas. Métodos: Estudo transversal com inclusão de 74 indivíduos e avaliação de variáveis antropométricas (índice de massa corporal [IMC], razão cintura-quadril [RCQ], circunferência abdominal [CA] e percentual de gordura corporal [PGC]), bioquímicas (glicemia, insulinemia, proteína C reativa ultrassensível, fibrinogênio, colesterol total, HDL-colesterol, triglicerídeos e LDL-colesterol) e função endotelial (DABMF, avaliada por ultrassonografia). A análise estatística foi realizada pelo programa SPSS, versão 16.0. Para estudar a associação entre as variáveis, foram utilizados os testes do qui-quadrado, t de Student, Mann-Whitney e correlação de Pearson. Regressão logística analisou a influência independente dos fatores. Valores de p < 0,05 foram considerados significativos. Resultados: Os participantes tinham uma média de idade de 50,8 anos e 57% eram do gênero feminino. O IMC, a CA, a RCQ e o PGC não mostraram associação significativa com a DABMF. O gênero masculino (p = 0,02) e níveis séricos mais elevados de fibrinogênio (p = 0,02) estiveram significativamente e independentemente associados a uma DABMF inferior a 8%. Conclusões: Em indivíduos com excesso de peso e dislipidemia leve não tratada, o gênero masculino e níveis mais elevados de fibrinogênio foram associados de forma independente com uma pior DABMF.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Fibrinogen/analysis , Endothelium, Vascular/physiopathology , Atherosclerosis/blood , Dyslipidemias/physiopathology , Overweight/physiopathology , Regional Blood Flow/physiology , Body Weight , Brachial Artery/physiopathology , Biomarkers/blood , Sex Factors , Anthropometry , Adipose Tissue/physiopathology , Cholesterol/blood , Cross-Sectional Studies , Risk Factors , Atherosclerosis/etiology , Dyslipidemias/complications , Overweight/complications
10.
Arq. bras. cardiol ; 106(1): 56-61, Jan. 2016. tab
Article in Portuguese | LILACS | ID: lil-771052

ABSTRACT

Abstract Background: Hemorheological and glycemic parameters and high density lipoprotein (HDL) cholesterol are used as biomarkers of atherosclerosis and thrombosis. Objective: To investigate the association and clinical relevance of erythrocyte sedimentation rate (ESR), fibrinogen, fasting glucose, glycated hemoglobin (HbA1c), and HDL cholesterol in the prediction of major adverse cardiovascular events (MACE) and coronary heart disease (CHD) in an outpatient population. Methods: 708 stable patients who visited the outpatient department were enrolled and followed for a mean period of 28.5 months. Patients were divided into two groups, patients without MACE and patients with MACE, which included cardiac death, acute myocardial infarction, newly diagnosed CHD, and cerebral vascular accident. We compared hemorheological and glycemic parameters and lipid profiles between the groups. Results: Patients with MACE had significantly higher ESR, fibrinogen, fasting glucose, and HbA1c, while lower HDL cholesterol compared with patients without MACE. High ESR and fibrinogen and low HDL cholesterol significantly increased the risk of MACE in multivariate regression analysis. In patients with MACE, high fibrinogen and HbA1c levels increased the risk of multivessel CHD. Furthermore, ESR and fibrinogen were significantly positively correlated with HbA1c and negatively correlated with HDL cholesterol, however not correlated with fasting glucose. Conclusion: Hemorheological abnormalities, poor glycemic control, and low HDL cholesterol are correlated with each other and could serve as simple and useful surrogate markers and predictors for MACE and CHD in outpatients.


Resumo Fundamento: Parâmetros hemorreológicos e glicêmicos e o HDL-colesterol são utilizados como biomarcadores da aterosclerose e trombose. Objetivo: Investigar a associação e a relevância clínica da velocidade de hemossedimentação (VHS), fibrinogênio, glicose de jejum, hemoglobina glicada (HbA1c) e HDL-colesterol na predição de eventos adversos cardiovasculares (EAC) importantes em pacientes ambulatoriais. Métodos: 708 pacientes estáveis ambulatoriais foram incluídos no estudo e acompanhados por um período médio de 28,5 meses. Os pacientes foram subdivididos em pacientes sem EAC e pacientes com EAC, que incluíram morte súbita cardíaca, infarto agudo do miocárdio, doença coronariana recém-diagnosticada, e acidente vascular cerebral. Comparamos os parâmetros hemorreológicos, glicêmicos, e perfis lipídicos entre os grupos. Resultados: Pacientes com EAC apresentaram níveis significativamente mais elevados de VHS, fibrinogênio, glicose de jejum, e HbA1c, e níveis mais baixos de HDL-colesterol em comparação a pacientes sem EAC. VHS e níveis de fibrinogênio elevados, e baixos níveis de HDL-colesterol aumentaram significativamente o risco de EAC em análise de regressão multivariada. Além disso, VHS e fibrinogênio correlacionaram-se positivamente com HbA1c e negativamente com HDL-colesterol, mas não se correlacionaram com glicose de jejum. Conclusão: Distúrbios hemorreológicos, baixo controle glicêmico e baixo nível de HDL-colesterol correlacionam-se entre si e podem ser usados como marcadores substitutos simples, úteis, e como preditores de EAC e doença coronariana em pacientes ambulatoriais.


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Blood Glucose/analysis , Cardiovascular Diseases/blood , Cholesterol, HDL/blood , Coronary Disease/blood , Fibrinogen/analysis , Glycated Hemoglobin A/analysis , Blood Sedimentation , Biomarkers/blood , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/etiology , Coronary Disease/diagnosis , Coronary Disease/etiology , Glycemic Index , Hemorheology , Outpatients , Predictive Value of Tests , Reproducibility of Results , Risk Factors , Statistics, Nonparametric
11.
J. pediatr. (Rio J.) ; 91(5): 464-470, Sept.-Oct. 2015. tab, graf
Article in English | LILACS | ID: lil-766171

ABSTRACT

ABSTRACT OBJECTIVES: To determine the prevalence of increased serum fibrinogen levels and its association with cardiometabolic risk factors in overweight or obese children and adolescents. METHODS: Cross-sectional study with 138 children and adolescents (overweight or obese) followed at a reference outpatient clinic of the public health care network. Fibrinogen concentration was divided into quartiles, and values above or equal to the third quartile were considered high. The association between high fibrinogen values and cardiometabolic risk factors was assessed using Pearson's chi-squared test or Fisher's exact test, as necessary. Logistic regression was used to adjust variables predictive of fibrinogen levels. Analyses were performed using SPSS version 22.0 and SAS software, considering a confidence interval of 95%. RESULTS: Serum fibrinogen levels were elevated in 28.3% of individuals, showing association with the presence of high CRP (p = 0.003, PR: 2.41, 95% CI: 1.30-4.46) and the presence of four or more risk factors (p = 0.042; PR: 1.78, 95% CI: 1.00-3.17). After a logistic regression, only elevated CRP remained associated with altered fibrinogen levels (p = 0.024; PR: 1.32; 95% CI: 1.09-5.25). CONCLUSIONS: Increased fibrinogen was prevalent in the study population and was associated with ultrasensitive C-reactive protein and the presence of four or more cardiovascular risk factors; it should be included in the assessment of individuals at risk.


RESUMO OBJETIVOS: Verificar a prevalência de níveis séricos elevados de fibrinogênio e sua associação com os fatores de risco cardiometabólicos em crianças e adolescentes com sobrepeso ou obesidade. MÉTODOS: Estudo transversal com 138 crianças e adolescentes (obesos ou com sobrepeso) acompanhados em um ambulatório de referência da rede pública. A concentração do fibrinogênio foi distribuída em quartis e considerada elevada quando os valores eram iguais ou superiores ao terceiro quartil. A associação entre o valor elevado do fibrinogênio com os fatores de risco cardiometabólicos foi verificada com o teste qui-quadrado de Pearson ou o teste exato de Fisher, quando necessário. A regressão logística foi usada para ajuste das variáveis preditoras do nível do fibrinogênio. As análises foram feitas no SPSS 22.0 e SAS e considerou-se o intervalo de confiança de 95%. RESULTADOS: Os níveis séricos de fibrinogênio estiveram elevados em 28,3% dos indivíduos e apresentaram associação com a PCR elevada (RP: 2,41; IC95%: 1,30-4,46, p = 0,003) e com a presença de quatro ou mais fatores de risco (RP: 1,78; IC95%: 1,00-3,17; p = 0,042). Após a regressão logística, apenas o PCR elevado continuou associado ao fibrinogênio alterado (RP: 1,32; IC95% 1,09-5,25; p = 0,024). CONCLUSÕES: O aumento do fibrinogênio foi prevalente na população estudada, esteve associado à proteína C reativa ultrassensível e ao número igual ou superior a quatro de fatores de risco cardiovasculares e deve ser incluído na avaliação de indivíduos sob risco.


Subject(s)
Adolescent , Child , Female , Humans , Male , Fibrinogen/analysis , Obesity/blood , Atherosclerosis/complications , Brazil , Biomarkers/analysis , C-Reactive Protein/analysis , Cross-Sectional Studies , Cardiovascular Diseases/blood , Cardiovascular Diseases/complications , Obesity/complications , Overweight/blood , Overweight/complications , Risk Factors
12.
Clinics ; 70(9): 601-605, Sept. 2015. tab
Article in English | LILACS | ID: lil-759294

ABSTRACT

OBJECTIVE:In this study, we aimed to compare the cardiovascular risk factors that might be associated with inflammation, atherosclerosis and metabolic syndrome between hemodialysis and peritoneal dialysis patients.METHODS:Fifty hemodialysis and 50 peritoneal dialysis patients who had been receiving dialysis therapy for at least one year were included in the study. Venous blood samples were taken after 12 hours of fasting, and serum glucose, triglyceride, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, fibrinogen and homocysteine levels were measured. The presence of atherosclerotic plaques in the carotid artery was evaluated by carotid Doppler ultrasound. These data were analyzed by Student’s t test, the chi-square test and the Mann-Whitney U test, as appropriate.RESULTS:No difference was found between the hemodialysis (n=50) and peritoneal dialysis (n=50) patient groups regarding mean age, gender distribution, body mass index or dialysis duration (p=0.269, 0.683, 0.426, and 0.052, respectively). LDL-cholesterol, fibrinogen and homocysteine levels were significantly higher in peritoneal dialysis patients (p=0.006, 0.001, and 0.002, respectively). In patients with diabetes mellitus (n=17) who were undergoing renal replacement therapy, LDL-cholesterol and fibrinogen levels were significantly higher than in patients without diabetes mellitus who were undergoing renal replacement therapy (p=0.001 and 0.004, respectively).CONCLUSION:In our study, cardiovascular risk factors (especially LDL-cholesterol) were more frequent in peritoneal dialysis patients than in hemodialysis patients.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Atherosclerosis/etiology , Inflammation/complications , Metabolic Syndrome/etiology , Peritoneal Dialysis/adverse effects , Body Mass Index , Blood Glucose/analysis , C-Reactive Protein/analysis , Cardiovascular Diseases/etiology , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Diabetes Mellitus/blood , Fibrinogen/analysis , Homocysteine/blood , Risk Factors , Renal Dialysis/adverse effects , Triglycerides/blood
13.
Arch. endocrinol. metab. (Online) ; 59(4): 318-324, Aug. 2015. tab, ilus
Article in English | LILACS | ID: lil-757373

ABSTRACT

Objective Oxidative damage may be responsible for the pathogenesis and complications of many diseases. Vitamin D deficiency has been suggested as a potential mediator of various extra-skeletal pathologies. However, there are limited data on anti-oxidant properties of vitamin D.Materials and methods Forty-one subjects with vitamin D deficiency and 30 healthy controls were enrolled into the study. The levels of total anti-oxidant status (TAS), total oxidant status (TOS), ischemia-modified albumin (IMA), oxidized-low density lipoprotein (ox-LDL), high-sensitivity C-reactive protein (hs-CRP) and fibrinogen were measured in both groups. The measurements were repeated in 17 patients after the replacement of vitamin D.Results Serum IMA and TOS levels were significantly higher (p < 0.001 and p = 0.035, respectively), while TAS levels were significantly lower in patients, compared to controls (p < 0.001). Additionally, fibrinogen was significantly higher in patients than controls (p = 0.003), while ox-LDL and hs-CRP levels were similar between two groups. After the replacement of vitamin D, TAS level significantly increased (p = 0.037), and TOS and fibrinogen levels significantly decreased (p = 0.043 and p = 0.010, respectively). Vitamin D levels were negatively correlated with IMA and fibrinogen levels (r = -0.500, p < 0.001 and r = -0.391, p = 0.002, respectively), although positively correlated with TAS levels (r = 0.430, p < 0.001). No correlation was found between vitamin D levels, and the TOS, ox-LDL and hs-CRP levels.Conclusions In this study, while serum IMA, TOS and fibrinogen levels were increased, TAS levels were seen to be decreased in patients with vitamin D deficiency. These results suggest that oxidative/anti-oxidative balance shifts in favours of oxidative status in vitamin D deficiency.


Subject(s)
Humans , Male , Female , Adult , Vitamin D Deficiency/blood , C-Reactive Protein/analysis , Fibrinogen/analysis , Oxidants/blood , Lipoproteins, LDL/blood , Serum Albumin , Biomarkers/blood , Case-Control Studies , Serum Albumin, Human
14.
Arq. neuropsiquiatr ; 73(1): 22-29, 01/2015. tab
Article in English | LILACS | ID: lil-732218

ABSTRACT

Objective To know the prevalence and factors associated to low cognitive performance in a representative sample of the adult population in a society aging progressively. Method Cross-sectional population-based study carried out in a three-stage sampling: 81 census tracts (primary sampling unity) were randomly selected, followed by 1,672 households and 2,471 participants (weighted sample) corresponding to the second and third stages, respectively. The outcome prevalence was calculated according sociodemographic, behavioral and health related variables. Crude and adjusted prevalence ratios were estimated using Poisson regression. Results The prevalence of low cognitive performance was high, mainly among females, and indicated linear trends into categories of age, schooling, income, plasma fibrinogen and self-reported health status. In multivariate models, gender, diabetes, fibrinogen and self-reported health status presented positive associations, while schooling, employment and sitting time presented negative associations with the outcome. Conclusion Interventions related to diabetes and fibrinogen levels control as well as improvement in health care might delay low cognitive performance in societies aging progressively as such the study population. .


Objetivo Estimar a prevalência e os fatores associados ao baixo desempenho cognitivo em amostra representativa de adultos pertencentes a uma população com envelhecimento progressivo. Método Estudo transversal, de base populacional, conduzido em amostra selecionada em três estágios: 81 setores censitários (unidade primária de amostragem) foram selecionados aleatoriamente, seguidos por 1.672 domicílios e 2.471 participantes (amostra ponderada), correspondendo ao segundo e terceiro estágios, respectivamente. A prevalência do desfecho foi calculada segundo fatores sociodemográficos, comportamentais e relacionados à saúde. Razões de prevalência brutas e ajustadas foram estimadas pela regressão de Poisson. Resultados A prevalência de baixo desempenho cognitivo foi elevada, principalmente nas mulheres, indicando gradiente linear em relação à idade, à escolaridade, à renda, aos níveis de fibrinogênio e à saúde autorreferida. Nos modelos multivariados, sexo, diabetes, fibrinogênio e saúde autorreferida apresentaram associações positivas, enquanto escolaridade, trabalho e tempo sentado apresentaram associações negativas com o desfecho. Conclusão ...


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Aging/blood , Cognition Disorders/blood , Diabetes Mellitus/blood , Fibrinogen/analysis , Brazil/epidemiology , Cross-Sectional Studies , Cognition Disorders/epidemiology , Diabetes Mellitus/epidemiology , Prevalence , Socioeconomic Factors
15.
Article in English | WPRIM | ID: wpr-195230

ABSTRACT

BACKGROUND/AIMS: This study investigated whether patients with acute promyelocytic leukemia (APL) truly fulfill the diagnostic criteria of overt disseminated intravascular coagulation (DIC), as proposed by the International Society on Thrombosis and Haemostasis (ISTH) and the Korean Society on Thrombosis and Hemostasis (KSTH), and analyzed which component of the criteria most contributes to bleeding diathesis. METHODS: A single-center retrospective analysis was conducted on newly diagnosed APL patients between January 1995 and May 2012. RESULTS: A total of 46 newly diagnosed APL patients were analyzed. Of these, 27 patients (58.7%) showed initial bleeding. The median number of points per patient fulfilling the diagnostic criteria of overt DIC by the ISTH and the KSTH was 5 (range, 1 to 7) and 3 (range, 1 to 4), respectively. At diagnosis of APL, 22 patients (47.8%) fulfilled the overt DIC diagnostic criteria by either the ISTH or KSTH. In multivariate analysis of the ISTH or KSTH diagnostic criteria for overt DIC, the initial fibrinogen level was the only statistically significant factor associated with initial bleeding (p = 0.035), but it was not associated with overall survival (OS). CONCLUSIONS: Initial fibrinogen level is associated with initial presentation of bleeding of APL patients, but does not affect OS.


Subject(s)
Adult , Aged , Biomarkers/blood , Chi-Square Distribution , Disseminated Intravascular Coagulation/blood , Female , Fibrinogen/analysis , Hemorrhagic Disorders/blood , Humans , Kaplan-Meier Estimate , Leukemia, Promyelocytic, Acute/blood , Logistic Models , Male , Middle Aged , Multivariate Analysis , Proportional Hazards Models , Republic of Korea , Retrospective Studies , Risk Factors , Young Adult
16.
ABCD arq. bras. cir. dig ; 28(1): 61-67, 2015. tab, graf
Article in English | LILACS | ID: lil-742745

ABSTRACT

BACKGROUND: Large number of surgical services use laparoscopy to approach the colon. One of the concerns on the resection using this way is the high rate of cancer relapse at in- and outlet site of the surgical instruments. AIM: To describe a protective device for surgical isolation in laparoscopic colectomy. METHODS: The device is made of sterile polyethylene plastic cover used to protect the fiber optic cable in laparoscopic surgery and one 20 Fr. urethral catheter working as a conduit. RESULTS: The device was used in six laparoscopic colectomies, three for adenocarcinoma of the colon and three for intestinal endometriosis. It was effective to avoid contact of the specimen with the abdominal wall, in order to reduce the risk of implantation of cancer or endometriotic cells and surgical site infection. The device was made intraoperative at all surgeries and allowed good visualization in laparoscopy and maintenance of the pneumoperitoneum. It cost R$ 22,00 (approximately US$ 10), R$14.50 related to the plastic cover and R$7.50, the urethral tube. The production time of the device and its installation in the abdominal cavity was measured in each procedure and was, on average, respectively, of 66 s and 25 s. CONCLUSION: The device proved to be feasible, not requiring any special training and can be performed by the surgical team itself, even at institutions with limited resources. .


RACIONAL: Grande número de serviços de cirurgia têm abordado laparoscopicamente do cólon. Uma das preocupações na ressecção dessa forma é o alto índice de recidivas de neoplasia nos orifícios de entrada dos instrumentais cirúrgicos. OBJETIVO: Descrever um dispositivo protetor para isolamento de peça cirúrgica em colectomia laparoscópica. MÉTODOS: O dispositivo é produzido por meio de plástico de polietileno estéril que usualmente é utilizado no envolvimento do cabo de fibra ótica em videocirurgia, como proteção, e por uma sonda uretral de 20 Fr, funcionando como um pertuito ou conduto. RESULTADOS: O dispositivo foi utilizado em seis colectomias laparoscópicas, três por adenocarcinoma de cólon e três por endometriose intestinal. Nestas operações, foi facilmente confeccionado no transoperatório. Mostrou-se efetivo para evitar o contato da peça cirúrgica com a parede abdominal, com o objetivo de reduzir o risco de implantação de células cancerosas ou endometrióticas e de infecção de sítio cirúrgico. Permitiu boa visualização na laparoscopia e manutenção do pneumoperitônio. Seu custo foi de R$ 22,00, sendo R$ 14,50 referentes à capa plástica e R$ 7,50, à sonda uretral. O tempo médio de confecção do dispositivo e de sua instalação na cavidade abdominal foi, respectivamente, de 66 s para confecção e de 25 s para instalação. CONCLUSÃO: A confecção do dispositivo ora apresentado mostrou-se viável, não requerendo qualquer treinamento especial e podendo ser executada pela própria equipe cirúrgica com custos reduzidos. .


Subject(s)
Bias , Epidemiologic Studies , Meta-Analysis as Topic , Multivariate Analysis , Regression Analysis , Cardiovascular Diseases/blood , Fibrinogen/analysis , Models, Statistical
17.
Yonsei Medical Journal ; : 921-927, 2015.
Article in English | WPRIM | ID: wpr-40873

ABSTRACT

PURPOSE: Although inconsistent, reports have shown fibrinogen levels to be associated with atherosclerosis. Accordingly, since cigarette smoking is associated with increased levels of fibrinogen and atherosclerosis, it may also affect the association between fibrinogen and atherosclerosis. We investigated the associations between fibrinogen and carotid intima-media thickness (IMT) according to smoking status in a Korean male population. MATERIALS AND METHODS: Plasma fibrinogen levels were measured in 277 men aged 40-87 years without a history of myocardial infarction or stroke. High-resolution B-mode ultrasonography was used to examine the common carotid arteries. IMT level was analyzed both as a continuous (IMT-max, maximum value; IMT-tpm, 3-point mean value) and categorical variable (higher IMT; presence of plaque). Serial linear and logistic regression models were employed to examine the association between fibrinogen and IMT according to smoking status. RESULTS: Fibrinogen levels were positively associated with IMT-max (standardized beta=0.25, p=0.021) and IMT-tpm (standardized beta=0.21, p=0.038), even after adjusting for age, body mass index, systolic blood pressure, fasting glucose, and total cholesterol to high-density lipoprotein cholesterol ratio in current smokers (n=75). No significant association between fibrinogen and IMT, however, was noted in former smokers (n=80) or nonsmokers (n=122). Adjusted odds ratios (95% confidence interval) for having plaque per one standard deviation higher fibrinogen level were 2.06 (1.09-3.89) for current smokers, 0.68 (0.43-1.10) for former smokers, and 1.06 (0.60-1.87) for nonsmokers. CONCLUSION: Our findings suggest that cigarette smoking may modify the association between fibrinogen and carotid atherosclerosis. Further studies are required to confirm this finding in different populations.


Subject(s)
Adult , Aged , Aged, 80 and over , Asians/statistics & numerical data , Atherosclerosis/diagnostic imaging , Blood Pressure , Body Mass Index , Carotid Artery Diseases/blood , Carotid Artery, Common , Carotid Intima-Media Thickness , Cholesterol/blood , Cholesterol, HDL , Cross-Sectional Studies , Fibrinogen/analysis , Humans , Lipoproteins, HDL/blood , Logistic Models , Male , Middle Aged , Republic of Korea/epidemiology , Risk Factors , Sex Factors , Smoking/adverse effects , Surveys and Questionnaires
18.
Pesqui. vet. bras ; 34(supl.1): 43-48, dez. 2014. tab
Article in English | LILACS, VETINDEX | ID: lil-778353

ABSTRACT

Magellanic penguins (Spheniscus magellanicus) usually arrive in poor body conditions at Brazilian beaches during the winter. Hematology provides valuable information about clinical and immunity status of the animals. The aims of this study were to determine the hematologic, total plasma protein (TPP) and fibrinogen profiles of young and adult magellanic penguins in PROAMAR and CETAS-SC, relating these results with the state of health and survival possibility of the animals. In Paraná 14 animals were evaluated in pre and eight in post-rehabilitation and 29 animals were evaluated in Santa Catarina after rehabilitation. Before rehabilitation, all animals showed weakness. In hematological exams of these animals, we found that anemia was present in 83% of the penguins that died and 50% of those which survived. The heterophils/lymphocytes (H/L) ratio was 3.87±0.57 in animals that died, significantly higher than the average of 2.20±0.30 for animals that survived. These two parameters are useful to assess the survival possibility of animals to rehabilitation. The body condition score was positively correlated with hematocrit and TPP, and negatively correlated with H/L ratio. After rehabilitation, the values were similar to other animals of the family Spheniscidae, with averages ranging from 1.64 to 1.90x106 erythrocytes/µL; 43.38 to 48.80% of hematocrit; 12.45 to 13.52g/dL of hemoglobin; 8,684 to 14,011 leukocytes/µL; 4,767 to 8,041 heterophils/µL; 3,215 to 4,951 lymphocytes/µL; 95 to 655 eosinophils/µl; 179.8 to 277.9 monocytes/µL; 141 to 184.9 basophils/µL; and 1.26 to 1.74 of H/L ratio. These parameters can therefore be used as reference values and release parameters for young and adult Magellanic penguins in captivity on the rehabilitation centers.(AU)


Pinguins-de-magalhães (Spheniscus magellanicus) geralmente chegam debilitados às praias do Brasil durante o inverno. A hematologia fornece informações valiosas sobre estado clínico e imunidade dos animais. Os objetivos do presente estudo foram determinar o perfil hematológico, de proteína plasmática total (PPT) e fibrinogênio de pinguins-de-magalhães jovens e adultos no PROAMAR e no CETAS-SC, relacionando esses resultados com o estado de saúde e possibilidade de sobrevivência dos animais. Foram avaliados no Paraná 14 animais na pré e oito na pós-reabilitação e 29 animais em Santa Catarina após a reabilitação. Antes da reabilitação, todos os animais apresentavam debilidade. Nos exames hematológicos desses animais, observou-se que a anemia estava presente em 83% dos pinguins que foram a óbito e em 50% dos que sobreviveram. A relação heterófilos/linfócitos (H/L) foi de 3,87±0,57 nos animais que foram a óbito, significativamente maior que a média de 2,20±0,30 dos animais que sobreviveram. Esses dois parâmetros são úteis na avaliação da possibilidade de sobrevivência dos animais à reabilitação. O escore corporal apresentou correlação positiva com hematócrito e PPT, e correlação negativa com relação H/L. Após a reabilitação os valores foram semelhantes aos de outros animais da família Spheniscidae, com médias variando de 1,64 a 1,90 x106 eritrócitos/µL; 43,38 a 48,80% de hematócrito; 12,45 a 13,52g/dL de hemoglobina; 8.684 a 14.011 leucócitos/µL; 4.767 a 8.041 heterófilos/µL; 3.215 a 4.951 linfócitos/µL; 95 a 655 eosinófilos/µL; 179,8 a 277,9 monócitos/µL; 141 a 184,9 basófilos/µL; e 1,26 a 1,74 de relação H/L. Esses parâmetros, portanto, podem ser utilizados como valores de referência e parâmetros para soltura para pinguins-de-magalhães jovens e adultos em cativeiro nos centros de reabilitação.(AU)


Subject(s)
Animals , Blood Cell Count/veterinary , Fibrinogen/analysis , Blood Proteins/analysis , Spheniscidae/blood , Anemia/rehabilitation
19.
Rev. bras. cir. cardiovasc ; 29(3): 330-337, Jul-Sep/2014. tab, graf
Article in English | LILACS, SES-SP | ID: lil-727173

ABSTRACT

Objective: The objective of this paper is to present the results from Spiral Pump clinical trial after design modifications performed at its previous project. This pump applies axial end centrifugal hydraulic effects for blood pumping during cardiopulmonary bypass for patients under cardiac surgery. Methods: This study was performed in 52 patients (51% males), between 20 to 80 (67±14.4) years old weighing 53 to 102 (71.7±12.6) kg, mostly under myocardial revascularization surgery (34.6%) and valvular surgery (32.8%). Besides the routine evaluation of the data observed in these cases, we monitored pump rotational speed, blood flow, cardiopulmonary bypass duration, urine free hemoglobin for blood cell trauma analysis (+ to 4+), lactate desidrogenase (UI/L), fibrinogen level (mg/dL) and platelet count (nº/mm3). Results: Besides maintaining appropriate blood pressure and metabolic parameters it was also observed that the Free Hemoglobin levels remained normal, with a slight increase after 90 minutes of cardiopulmonary bypass. The Lactate Dehydrogenase showed an increase, with medians varying between 550-770 IU/L, whereas the decrease in Fibrinogen showed medians of 130-100 mg/dl. The number of platelets showed a slight decrease with the medians ranging from 240,000 to 200,000/mm3. No difficulty was observed during perfusion terminations, nor were there any immediate deaths, and all patients except one, were discharged in good condition. CONCLUSION: The Spiral Pump, as blood propeller during cardiopulmonary bypass, demonstrated to be reliable and safe, comprising in a good option as original and national product for this kind of application. .


Objetivos: Apresentar resultados da aplicação da bomba espiral que emprega efeitos hidráulicos centrífugo e axial de bombeamento como elemento propulsor do circuito de circulação extracorpórea em pacientes submetidos a cirurgias cardíacas após modificações introduzidas no design do projeto original. Métodos: O estudo foi realizado em 52 pacientes (51% masculinos), com idade entre 20 a 80 (67±14,4) anos, peso 53 a 102 (71,7±12,6) kg, submetidos na maioria a cirurgia de revascularização miocárdica (34,6%) e Orovalvar (32,8%). Além das avaliações rotineiras, foram registrados rotação, tempo de CEC e para análise do impacto traumático à crase sanguínea, hemoglobina livre na urina (+ a 4+), desidrogenase láctica, fibrinogênio (mg/dL) e contagem de plaquetas (nº/mm3). Resultados: Observou-se a manutenção de parâmetros pressóricos e metabólicos adequados. Quanto aos marcadores de danos à crase sanguínea, as alterações estiveram proporcionais ao tempo maior de circulação extracorpórea. Os níveis de Hemoglobina Livre permaneceram com valores normais, com ligeiro aumento a partir dos 90 minutos de circulação extracorpórea. A Desidrogenase Láctica mostrou aumento, variando as medianas entre 550 a 770 UI/L enquanto o Fibrinogênio mostrou queda das medianas de 130 a 100 mg/dl. O número de plaquetas mostrou ligeira queda das medianas variando entre 240.000 a 200.000/mm3. Não ocorreram dificuldades de saída de perfusão, não se observou óbito imediato e todos os pacientes, exceto 1, obtiveram alta hospitalar. Conclusão: A bomba espiral aplicada como bomba propulsora de sangue durante cirurgia cardíaca se mostrou confiável e segura, não causou impacto traumático ...


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Cardiac Surgical Procedures/instrumentation , Cardiopulmonary Bypass/instrumentation , Heart-Assist Devices/standards , Cardiac Surgical Procedures/methods , Cardiopulmonary Bypass/methods , Equipment Design/standards , Equipment Safety , Fibrinogen/analysis , L-Lactate Dehydrogenase/blood , Medical Illustration , Models, Cardiovascular , Platelet Count , Reproducibility of Results , Statistics, Nonparametric , Time Factors , Treatment Outcome
20.
Clinics ; 69(6): 405-412, 6/2014. tab
Article in English | LILACS | ID: lil-712694

ABSTRACT

OBJECTIVES: This study aimed to investigate the clinical correlation between angiographic coronary atherosclerosis and N-terminal pro-B-type natriuretic peptide along with other known correlated factors. METHODS: In total, 153 patients with a diagnostic hypothesis of stable angina, unstable angina or acute myocardial infarction were classified as group A (patients with angiographically normal coronary arteries) or group B (patients with angiographic coronary atherosclerosis). The two groups were analyzed with respect to the following factors: gender, age, body mass index, abdominal circumference, smoking, diabetes mellitus, arterial hypertension, early family history of atherosclerosis, statin use, the presence of metabolic syndrome, clinical presentation and biochemical factors, including cholesterol, creatinine and fibrinogen plasma concentrations, monocyte counts and N-terminal pro-B-type natriuretic peptide. RESULTS: Univariate analyses comparing the two groups revealed that group B patients more frequently had diabetes, used statins and had systolic dysfunction, N-terminal pro-B-type natriuretic peptide levels ≥250 pg/mL, fibrinogen levels >500 mg/dL and ≥501 monocytes/mm3 compared with group A patients (p<0.05). Nevertheless, multivariate logistic regression analysis demonstrated that the independent predictors of angiographic coronary atherosclerosis were an N-terminal pro-B-type natriuretic peptide level ≥250 pg/mL, diabetes mellitus and increased monocyte numbers and fibrinogen plasma concentration, regardless of the creatinine level or the presence of systolic dysfunction. CONCLUSIONS: An N-terminal pro-B-type natriuretic peptide plasma concentration of ≥250 pg/mL is an independent predictor of angiographic coronary atherosclerosis. .


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Atherosclerosis/blood , C-Reactive Protein/analysis , Coronary Artery Disease/blood , Fibrinogen/analysis , Natriuretic Peptide, Brain/blood , Peptide Fragments/blood , Atherosclerosis , Biomarkers/blood , Coronary Angiography , Coronary Artery Disease , Risk Factors , Severity of Illness Index
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