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1.
Rev. cuba. anestesiol. reanim ; 18(3): e503, sept.-dic. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1093116

ABSTRACT

Introducción: Una serie de breves periodos de isquemias a distancia pueden limitar el daño miocárdico producido por la isquemia/reperfusión. Objetivo: Analizar las diferencias entre los dos grupos (control y estudio) teniendo en cuanta el consumo de inotrópicos y/o vasopresores durante los períodos intra y posoperatorio, así como, incidencia de eventos adversos cardiacos mayores y mortalidad en el postoperatorio. Métodos: Se realizó un estudio cuasiexperimental, explicativo, comparativo con control histórico, en dos grupos de 247 pacientes, propuestos para revascularización coronaria. Se colocó un torniquete en el brazo derecho, en el grupo estudio, alternando 3 insuflaciones con 3 desinsuflaciones con una presión de 200 mmHg, manteniéndola 5 min cada una. Este proceder se realizó previo, durante y después del evento isquémico mayor, provocado por el pinzamiento de la arteria coronaria. Resultados: Se logró una disminución significativa del consumo de drogas inotrópicas y vasoactivas. Se comprobó además, la disminución en la incidencia de bajo gasto cardiaco reversible, fibrilación ventricular, nuevo infarto agudo de miocardio. Conclusiones: El condicionamiento isquémico a distancia es una importante herramienta a tener en cuenta para la protección cardiaca perioperatoria en la revascularización coronaria(AU)


Introduction: A series of brief distant ischemia periods can limit myocardial damage produced by ischemia or reperfusion. Objective: To analyze the differences between the two groups (control and study) taking into account the consumption of inotropics and/or vasopressors during the intraoperative and postoperative periods, as well as the incidence of major cardiac adverse events and mortality in the postoperative period. Methods: A quasiexperimental, explanatory and comparative study with historical control was conducted on two groups of 247 patients proposed for coronary revascularization. A tourniquet was placed to the right arm, in the study group, alternating three insufflations with three dessufflations with a pressure of 200 mmHg, keeping each for five minutes. This procedure was performed before, during and after the major ischemic event, caused by pinching of the coronary artery. Results: A significant decrease in the consumption of inotropic and vasoactive drugs was achieved. The decrease in the incidence of low reversible cardiac output, ventricular fibrillation, and new acute myocardial infarction was also proven. Conclusions: Distant ischemic conditioning is an important tool to be taken into account for perioperative cardiac protection in coronary revascularization(AU)


Subject(s)
Humans , Myocardial Reperfusion , Ischemic Postconditioning/methods , Ischemia/prevention & control , Myocardial Revascularization/methods , Perioperative Care/methods , Non-Randomized Controlled Trials as Topic
2.
Acta cir. bras ; 34(8): e201900806, 2019. tab, graf
Article in English | LILACS | ID: biblio-1038123

ABSTRACT

Abstract Purpose To assess Cyclosporine A (CsA) therapy at an intraperitoneal dose of 15 mg.kg -1 in a rodent model of non-septic renal ischemia. Methods Twenty male Wistar rats were randomized to receive CsA therapy or none therapy before undergoing 30 minutes of renal ischemia followed by reperfusion. Additionally, 10 rats were randomized to undergo the same surgical procedure of the aforementioned animals with neither ischemia nor CsA therapy. Twelve hours after kidney ischemia, the left kidneys were evaluated for histological injury according to Park's criteria. Serum creatinine (Cr), urea nitrogen (Ur) and sodium levels were obtained at different times of the experimental protocol. Results Rodents in the CsA group showed negative results (p<0.05) in serum variables (Cr: 0.41±0.05mg/dL vs . 4.17±1.25mg/dL; Ur: 40.90±3.98mg/dL vs . 187.70±22.93mg/dL) even the non CsA or control group (Cr: 0.35±0.07mg/dL vs . 3.80±1.20mg/dL; Ur: 40.10±4.70mg/dL vs . 184.50±49.80mg/dL). The negative results were also verified in histological evaluation, CsA group had 50% in the very severe grade of lesion, 10% in the severe and 40% in the moderate to severe whereas the control group had 90% in the very severe grade. Conclusion CsA was incapable of preventing the deleterious effects of ischemia-reperfusion injury in rat kidneys.


Subject(s)
Animals , Male , Rats , Reperfusion Injury/drug therapy , Cyclosporine/pharmacology , Immunosuppressive Agents/pharmacokinetics , Kidney/blood supply , Sodium/blood , Urea/blood , Reperfusion Injury/pathology , Rats, Wistar , Creatinine/blood , Disease Models, Animal , Ischemia/prevention & control , Kidney/drug effects
3.
Acta cir. bras ; 34(8): e201900805, 2019. tab, graf
Article in English | LILACS | ID: biblio-1038124

ABSTRACT

Abstract Purpose To investigate the effect of sevoflurane preconditioning on ischemia/reperfusion (I/R)-induced pulmonary/hepatic injury Methods Fifty-one Wistar rats were randomly grouped into sham, I/R, and sevoflurane groups. After reperfusion, the structural change of the lung was measured by Smith score, the wet and dry weights (W/D) were determined, malondialdehyde (MDA) myeloperoxidase (MPO) content was determined colorimetrically and by fluorescence, respectively, and matrix metalloprotein-9 (MMP-9) mRNA was quantified by RT-PCR. Biopsy and morphological analyses were performed on liver tissue, activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were determined, and tumor necrosis factor-alpha (TNF-α) level was determined. Results The sham group showed no changes in tissue structure. Structural lesions in the sevoflurane and I/R groups were mild and severe, respectively. Smith score, W/D, MDA, MPO, and MMP mRNA showed the same trend, and were increased in the I/R group and recovered in the sevoflurane group, compared with the sham group (both P<0.05). AST and ALT were significantly increased compared to the sham group (AST: 655±52.06 vs . 29±9.30 U/L; ALT: 693±75.56 vs . 37±6.71 U/L; P<0.05). In the sevoflurane group, AST and ALT levels were significantly decreased (464±47.71 and 516±78.84 U/L; P<0.001). TNF-α presented similar results. Conclusion The protection of lung and liver by sevoflurane may be mediated by inhibited leukocyte recruitment and MMP-9 secretion.


Subject(s)
Animals , Male , Rats , Reperfusion Injury/prevention & control , Anesthetics, Inhalation/therapeutic use , Ischemic Preconditioning/methods , Liver/blood supply , Lung/blood supply , Aspartate Aminotransferases/blood , Reperfusion Injury/drug therapy , Tumor Necrosis Factor-alpha/blood , Peroxidase/analysis , Alanine Transaminase/blood , Disease Models, Animal , Sevoflurane/therapeutic use , Ischemia/prevention & control , Liver/drug effects , Liver/pathology , Lung/drug effects , Lung/pathology , Malondialdehyde/analysis
4.
Acta cir. bras ; 33(7): 597-608, July 2018. graf
Article in English | LILACS | ID: biblio-949363

ABSTRACT

Abstract Purpose: To compare early- and late-effect remote ischemic preconditioning (RIPC) by analysing the microcirculatory, hemodynamic and histological changes in partial liver ischemia-reperfusion of rats. Methods: 60-minute partial liver ischemia followed by 120-minute reperfusion was performed without (Control group, n=7) or with preconditioning. In RIPC groups a tourniquet was applied around the left thigh using 3 cycles of 10-minute ischemia/10-minute reperfusion, one (RIPC-1, n=7) or twenty-four hours (RIPC-24, n=7) before I/R. Hemodynamic and microcirculatory measurements were performed before and after ischemia and in 30th, 60th and 120th minute of reperfusion and histological examination at the end of reperfusion. Results: Blood pressure decreased in all groups followed by biphasic changes in Control group. In RIPC groups R120 values returned almost to normal. Heart rate increased in Control and RIPC-1 groups at R120, while RIPC-24 did not show significant changes. Microcirculation of non-ischemic liver stayed constant in Control and showed significant changes in RIPC-24 group, while in ischemic liver elevated by R120 in all groups. RIPC didn't reduce histological alterations. Conclusion: Considering the survival and the results, both remote ischemic preconditioning protocols had beneficial effect in hepatic ischemia-reperfusion, however the histopathological findings were controversial.


Subject(s)
Animals , Rats , Reperfusion Injury/prevention & control , Ischemic Preconditioning/methods , Ischemia/prevention & control , Liver/blood supply , Microcirculation/physiology , Temperature , Time Factors , Blood Pressure/physiology , Random Allocation , Reproducibility of Results , Treatment Outcome , Laser-Doppler Flowmetry , Disease Models, Animal , Respiratory Rate/physiology , Liver/pathology
5.
Int. braz. j. urol ; 44(3): 617-622, May-June 2018. graf
Article in English | LILACS | ID: biblio-954058

ABSTRACT

ABSTRACT Objective: To investigate the effect of papaverine and alprostadil on testicular torsion-detorsion injury in rats. Materials and Methods: A total of 40 male Wistar-Albino rats were used in this study. Four hours of right testicular torsion was applied to each group, excluding sham oper- ated group. The torsion-detorsion (T/D), T/D + papaverine and T/D + alprostadil groups received saline, papaverine and alprostadil at the same time as surgical detorsion, respectively. At 14 days after the surgical detorsion, ischaemic changes and the degree of damage were evaluated with Cosentino scoring and the Johnson tubular biopsy score (JTBS). Results: JTBS was determined as 8.8±2.7 in the Sham group, 5.08±1.9 in the T/D+papaverine group, 5.29±2.3 in the T/D +alprostadil group and 2.86±1.9 in the TD group. The JTBS was determined to be statistically significantly high in both the T/D + papaverine group and the T/D + alprostadil group compared to the T/D group (p=0.01, p=0.009). In the T/D + papaverine group, 3 (43%) testes were classified as Cosentino 2, 3 (43%) as Cosentino 3 and 1 (14%) as Cosentino 4. In the T/D +alprostadil group, 5 (50 %) testes were classified as Cosentino 2, 3 (30 %) as Cosentino 3 and 2 (20%) as Cosentino 4. Conclusion: The present study indicated that spermatic cord administration of alprostadil and papaverine showed a protective effect against ischemia/reperfusion injury after right-side testes torsion and histological changes were decreased after testicular ischemia reperfusion injury.


Subject(s)
Animals , Male , Papaverine/therapeutic use , Spermatic Cord Torsion/prevention & control , Testis/blood supply , Vasodilator Agents/pharmacology , Alprostadil/pharmacology , Ischemia/prevention & control , Papaverine/pharmacology , Spermatic Cord Torsion/pathology , Testis/pathology , Vasodilator Agents/therapeutic use , Biopsy , Severity of Illness Index , Alprostadil/therapeutic use , Reperfusion Injury/prevention & control , Random Allocation , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Protective Agents/therapeutic use , Protective Agents/pharmacology
6.
Rev. bras. cir. cardiovasc ; 33(3): 258-264, May-June 2018. tab, graf
Article in English | LILACS | ID: biblio-958409

ABSTRACT

Abstract Objective: The injury-reducing effect of acetaminophen, an effective analgesic and antipyretic on ischemia-reperfusion continues to attract great attention. This study analyzed the protective effect of acetaminophen on myocardial injury induced by ischemia-reperfusion in an experimental animal model from lower extremity ischemia-reperfusion. Methods: Twenty-four Sprague-Dawley female rats were randomized into three groups (n=8) as (i) control group (only laparotomy), (ii) aortic ischemia-reperfusion group (60 min of ischemia and 120 min of reperfusion) and (iii) ischemia-reperfusion + acetaminophen group (15 mg/kg/h intravenous acetaminophen infusion starting 15 minutes before the end of the ischemic period and lasting till the end of the reperfusion period). Sternotomy was performed in all groups at the end of the reperfusion period and the heart was removed for histopathological examination. The removed hearts were histopathologically investigated for myocytolysis, polymorphonuclear leukocyte (PMNL) infiltration, myofibrillar edema and focal hemorrhage. Results: The results of histopathological examination showed that acetaminophen was detected to particularly diminish focal hemorrhage and myofibrillar edema in the ischemia-reperfusion + acetaminophen group (P<0.001, P=0.011), while there were no effects on myocytolysis and PMNL infiltration between the groups (P=1.000, P=0.124). Conclusion: Acetaminophen is considered to have cardioprotective effect in rats, by reducing myocardial injury induced by abdominal aortic ischemia-reperfusion.


Subject(s)
Humans , Animals , Female , Cardiotonic Agents/pharmacology , Myocardial Reperfusion Injury/prevention & control , Lower Extremity/blood supply , Acetaminophen/pharmacology , Aorta, Abdominal/pathology , Reference Values , Time Factors , Myocardial Reperfusion Injury/pathology , Random Allocation , Rats, Sprague-Dawley , Constriction , Disease Models, Animal , Edema, Cardiac/pathology , Ischemia/prevention & control , Ischemia/blood , Myofibrils/pathology
7.
Rev. bras. cir. cardiovasc ; 33(2): 115-121, Mar.-Apr. 2018. tab, graf
Article in English | LILACS | ID: biblio-958394

ABSTRACT

Abstract Objective: The aim of the present study was to evaluate the ability of ischemic postconditioning, atorvastatin and both associated to prevent or minimize reperfusion injury in the lung of rats subjected to ischemia and reperfusion by abdominal aortic clamping. Methods: We used 41 Wistar norvegic rats, which were distributed into 5 groups: ischemia and reperfusion (I/R), ischemic postcondictioning (IPC), postconditioning + atorvastatin (IPC+A), atorvastatin (A) and SHAM. It was performed a medium laparotomy, dissection and isolation of the infra-renal abdominal aorta; except for the SHAM group, all the others were submitted to the aortic clamping for 70 minutes (ischemia) and posterior clamp removal (reperfusion, 70 minutes). In the IPC and IPC+A groups, postconditioning was performed between the ischemia and reperfusion phases by four cycles of reperfusion and ischemia lasting 30 seconds each. In the IPC+A and A groups, preceding the surgical procedure, administration of 3.4 mg/day of atorvastatin was performed for seven days by gavage. After the surgical procedure, the right caudal lobe was removed from the lung for histological study, using tissue injury score ranging from grade 1 (normal tissue) to grade 4 (intense lesion). Results: The mean lung injury was 3.6 in the I/R group, 1.6 in the IPC group, 1.2 in the IPC+A group, 1.2 in the A group, and 1 in the SHAM group (P<0.01). Conclusion: Ischemic postconditioning and atorvastatin were able to minimize lung reperfusion injury, alone or in combination.


Subject(s)
Animals , Male , Reperfusion Injury/prevention & control , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Ischemic Postconditioning/methods , Atorvastatin/therapeutic use , Lung/blood supply , Aorta, Abdominal , Time Factors , Reperfusion Injury/pathology , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Combined Modality Therapy , Ischemia/pathology , Ischemia/prevention & control , Lung/pathology
8.
Int. braz. j. urol ; 44(1): 53-62, Jan.-Feb. 2018. tab
Article in English | LILACS | ID: biblio-892939

ABSTRACT

ABSTRACT Introduction Super-selective clamping of tumor-specific segmental arteries was developed to eliminate ischemia of the remnant kidney while limiting hemorrhage during partial nephrectomy. The objective is to evaluate the benefice of super-selective clamping on renal functional outcome, compared to early-unclamping of the renal artery. Materials and Methods From March 2015 to July 2016, data from 30 patients undergoing super-selective robot-assisted PN (RAPN) for a solitary tumor by a single surgeon were prospectively collected. Tumor devascularization was assessed using indocyanine green near-infrared fluorescence. A matched-pair analysis with a retrospective cohort undergoing early-unclamping was conducted, adjusting on tumor complexity and preoperative eGFR. Perioperative, oncologic and functional outcomes using DMSA-renal scintigraphy were assessed. Multivariate analysis was performed to identify predictors of postoperative renal function and de novo chronic kidney disease (CKD). Results Super-selective RAPN was successful in 23/30 patients (76.7%), 5 requiring secondary main artery clamping due to persistent tumor fluorescence. Matched-pair analysis showed similar operating time, blood loss, positives margins and complication rates. Super-selective clamping was associated with an improved eGFR variation at discharge (p=0.002), 1-month (p=0.01) and 6-month post-op (-2%vs-16% p=0.001). It also led to a better relative function on scintigraphy (46%vs40% p=0.04) and homolateral eGFR (p=0.04), and fewer upstaging to CKD stage ≥3 (p=0.03). On multivariate analysis, super-selective clamping was a predictor of postoperative renal function. Conclusion Super-selective RAPN leads to an improved preservation of renal function and a reduced risk of de novo CKD stage≥3, while keeping the benefit of main artery clamping on perioperative outcomes.


Subject(s)
Humans , Male , Female , Aged , Renal Artery , Robotic Surgical Procedures/methods , Ischemia/prevention & control , Kidney Neoplasms/surgery , Kidney Neoplasms/blood supply , Nephrectomy/methods , Postoperative Care , Retrospective Studies , Treatment Outcome , Minimally Invasive Surgical Procedures , Constriction , Spectroscopy, Near-Infrared , Middle Aged
9.
Acta cir. bras ; 33(1): 1-13, Jan. 2018. tab, graf
Article in English | LILACS | ID: biblio-886254

ABSTRACT

Abstract Purpose: To investigate the effect of dexmedetomidine (Dex) in a rat ex vivo lung model of ischemia-reperfusion injury. Methods: An IL-2 ex vivo lung perfusion system was used to establish a rat ex vivo lung model of ischemia-reperfusion injury. Drugs were added to the perfusion solution for reperfusion. Lung injury was assessed by histopathological changes, airway pressure (Res), lung compliance (Compl), perfusion flow (Flow), pulmonary venous oxygen partial pressure (PaO2), and lung wet/dry (W/D) weight ratio. The levels of superoxide dismutase (SOD), malondialdehyde (MDA), 78 kDa glucose-regulated protein (GRP78) and CCAAT/enhancer-binding protein homologous protein (CHOP) were measured, respectively. Results: The introduction of Dex attenuated the post-ischemia-reperfusion lung damage and MDA level, improved lung histology, W/D ratio, lung injury scores and SOD activity. Decreased mRNA and protein levels of GRP78 and CHOP compared with the IR group were observed after Dex treatment. The effect of Dex was dosage-dependence and a high dose of Dex (10 nM) was shown to confer the strongest protective effect against lung damage (P<0.05). Yohimbine, an α2 receptor antagonist, significantly reversed the protective effect of Dex in lung tissues (P<0.05). Conclusion: Dex reduced ischemia-reperfusion injury in rat ex vivo lungs.


Subject(s)
Animals , Male , Reperfusion Injury/prevention & control , Dexmedetomidine/pharmacology , Adrenergic alpha-2 Receptor Agonists/pharmacology , Ischemia/prevention & control , Lung/blood supply , Reference Values , Superoxide Dismutase/analysis , Time Factors , Reperfusion Injury/pathology , Blotting, Western , Reproducibility of Results , Treatment Outcome , Rats, Sprague-Dawley , CCAAT-Enhancer-Binding Proteins/analysis , Disease Models, Animal , Real-Time Polymerase Chain Reaction , Heat-Shock Proteins/analysis , Lung/pathology , Malondialdehyde/analysis
10.
Acta cir. bras ; 32(8): 599-606, Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-886224

ABSTRACT

Abstract Purpose: To evaluate if combination of perconditioning and postconditioning provides improved renal protection compared to perconditioning alone in a model of renal reperfusion injury. Methods: Thirty rats were assigned into 6 groups: normality; sham; ischemia and reperfusion; postconditioning; perconditioning; perconditioning + postconditioning. Animals were subjected to right nephrectomy and left renal ischemia for 30 minutes. Postconditioning consisted of 3 cycles of 5 min renal perfusion followed by 5 min of renal ischemia after major ischemic period. Perconditioning consisted of 3 cycles of 5 min hindlimb ischemia followed by 5 min of hindlimb perfusion contemporaneously to renal major ischemic period. After 24 hours, kidney was harvested and blood collected to measure urea and creatinine. Results: Perconditioning obtained better values for creatinine and urea level than only postconditioning (p<0.01); performing both techniques contemporaneously had no increased results (p>0.05). Regarding tissue structure, perconditioning was the only technique to protect the glomerulus and tubules (p<0.05), while postconditioning protected only the glomerulus (p<0.05). Combination of both techniques shows no effect on glomerulus or tubules (p>0.05). Conclusions: Perconditioning had promising results on ischemia and reperfusion induced kidney injury, enhanced kidney function and protected glomerulus and tubules. There was no additive protection when postconditioning and perconditioning were combined.


Subject(s)
Animals , Male , Reperfusion Injury/prevention & control , Ischemic Preconditioning/methods , Ischemic Postconditioning/methods , Ischemia/prevention & control , Kidney/blood supply , Time Factors , Random Allocation , Reproducibility of Results , Rats, Wistar , Models, Animal , Kidney/pathology
11.
Acta cir. bras ; 32(3): 211-218, Mar. 2017. tab, graf
Article in English | LILACS | ID: biblio-837686

ABSTRACT

Abstract Purpose: To evaluate the effects of hypertonic saline solution associated to remote ischemic perconditioning in renal ischemia/reperfusion injury in rats. Methods: Twenty five male rats (Wistar) underwent right nephrectomy and were distributed into five groups: Sham group (S); Ischemia/Reperfusion group (I/R) with 30 minutes of renal ischemia; Remote ischemic perconditioning group (Per) with three cycles of 10 minutes of I/R performed during kidney ischemia; Hypertonic saline solution group (HSS) treated with hypertonic saline solution (4ml/kg); remote ischemic perconditioning + Hypertonic saline solution group (Per+HSS) with both treatments. After reperfusion, blood samples were collected for BUN and creatinine serum levels analyzes. TBARS were evaluated in plasma and renal tissue to assess oxidative stress. Kidney histopathological examination were performed. Results: Per+HSS group showed a lower degree of renal dysfunction in relation to I/R group, whereas the technique of remote ischemic perconditioning isolated or associated with saline solution significantly reduced oxidative stress and histological damage. Conclusion: Remote ischemic perconditioning associated or not to saline solution promoted reduction of acute renal injury induced by ischemia/reperfusion.


Subject(s)
Animals , Male , Saline Solution, Hypertonic/pharmacology , Reperfusion Injury/prevention & control , Ischemic Preconditioning/methods , Protective Agents/pharmacology , Ischemia/prevention & control , Kidney/blood supply , Thiobarbiturates/analysis , Time Factors , Blood Urea Nitrogen , Random Allocation , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Oxidative Stress , Creatinine/blood , Kidney/physiopathology , Kidney/pathology , Kidney/chemistry , Kidney Function Tests , Necrosis
12.
Acta cir. bras ; 32(3): 203-210, Mar. 2017. tab
Article in English | LILACS | ID: biblio-837689

ABSTRACT

Abstract Purpose: To investigate the effects of cyclosporine A on renal ischemia-reperfusion injury during transient hyperglycemia in rats. Methods: In a model of ischemia-reperfusion-induced renal injury and transiently induced hyperglycemia by intraperitoneal injection of glucose, 2.5 g.kg-1, Wistar rats were anesthetized with either isoflurane or propofol and received intravenous cyclosporine A, 5 mg.kg-1, five minutes before reperfusion. Comparison groups were isoflurane and propofol sham groups and isoflurane and propofol ischemia-reperfusion-induced renal injury. Renal tubular cell viability was quantitatively assessed by flow cytometry after cell culture and classified as early apoptosis, necrotic cells, and intact cells. Results: Early apoptosis was significantly higher in isoflurane and propofol anesthetized animals subjected to renal ischemia-reperfusion injury when compared to both cyclosporine A treated and sham groups. Necrosis percentage was significantly higher in propofol-anesthetized animals subjected to renal ischemia-reperfusion injury. The percentage of intact cells was lower in both, isoflurane and propofol anesthetized animals subjected to renal ischemia-reperfusion injury. Conclusion: In a model of ischemia-reperfusion-induced renal injury, cyclosporine A, 5 m.kg-1, administered five minutes before renal reperfusion in rats with acute-induced hyperglycemia under either isoflurano or propofol anesthesia, attenuated early apoptosis and preserved viability in renal tubular cells, regardless of the anesthetic used.


Subject(s)
Animals , Male , Reperfusion Injury/prevention & control , Cyclosporine/pharmacology , Apoptosis/drug effects , Protective Agents/pharmacology , Hyperglycemia/physiopathology , Kidney/drug effects , Premedication , Time Factors , Reperfusion Injury/complications , Random Allocation , Propofol/pharmacology , Cell Survival/drug effects , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Anesthetics, Intravenous/pharmacology , Anesthetics, Inhalation/pharmacology , Flow Cytometry , Ischemia/prevention & control , Isoflurane/pharmacology , Kidney/blood supply , Kidney/pathology , Necrosis/prevention & control
13.
Acta cir. bras ; 32(3): 229-235, Mar. 2017. tab, graf
Article in English | LILACS | ID: biblio-837690

ABSTRACT

Abstract Purpose: To evaluate the effects of tramadol hydrochloride associated to remote ischemic perconditioning on oxidative stress. Methods: Twenty five male rats (Wistar) underwent right nephrectomy and were distributed into five groups: Sham group (S); Ischemia/Reperfusion group (I/R) with 30 minutes of renal ischemia; Remote ischemic perconditioning group (Per) with three cycles of 10 minutes of I/R performed during kidney ischemia; Tramadol group (T) treated with tramadol hydrochloride (40mg/kg); remote ischemic perconditioning + Tramadol group (Per+T) with both treatments. Oxidative stress was assessed after 24 hours of reperfusion. Results: Statistical differences were observed in MDA levels between I/R group with all groups (p<0.01), in addition there was difference between Tramadol with Sham, Per and Per+T groups (p<0.05), both in plasma and renal tissue. Conclusion: Remote ischemic perconditioning was more effective reducing renal ischemia-reperfusion injury than administration of tramadol or association of both treatments.


Subject(s)
Animals , Male , Tramadol/pharmacology , Reperfusion Injury/prevention & control , Oxidative Stress/drug effects , Ischemic Preconditioning/methods , Protective Agents/pharmacology , Ischemia/prevention & control , Kidney/blood supply , Time Factors , Reperfusion Injury/metabolism , Random Allocation , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Combined Modality Therapy/methods , Oxidative Stress/physiology , Ischemia/metabolism , Kidney/metabolism , Malondialdehyde/analysis
14.
J. vasc. bras ; 15(2): 93-98, tab, ilus
Article in English | LILACS | ID: lil-787531

ABSTRACT

BACKGROUND: Venous arterialization has been adopted as a strategy for salvage of limbs in critical ischemia without the distal arterial bed, with successful outcomes, but the mechanisms by which irrigation of the extremities takes place are still unknown. OBJECTIVES: To develop an experimental model to test hypotheses that could explain the mechanisms of blood supply in venous arterialization. METHODS: Eleven pigs underwent a period of hind limb ischemia followed by reperfusion achieved by venous arterialization, after interposition of conduits filled with 10 ml (5 animals - group 1) or 1 ml (6 animals - group 2) of China Ink. After euthanasia, the limbs were amputated and underwent histological analysis. RESULTS: Under optical microscopy, ink staining was observed in the arteriolar lumen of six (55%) of the eleven pigs used in the experiment; four (80%) out of five from group 1 and two (33%) out of six from group 2. CONCLUSIONS: The experimental model was capable of testing the hypothesis. The presence of China Ink in the arteriolar lumen shows that it is possible to supply the arterial vessels by means of venous arterialization.


CONTEXTO: A arterialização venosa tem sido adotada com bons resultados como estratégia para salvar membros em isquemia crítica sem leito arterial distal. No entanto, os mecanismos pelos quais a irrigação das extremidades ocorre permanecem desconhecidos. OBJETIVOS: Desenvolver um modelo experimental para testar hipóteses que podem explicar os mecanismos de nutrição em arterialização venosa. MÉTODOS: Onze porcos foram submetidos a um período de isquemia seguida de reperfusão do membro posterior, realizada por arterialização venosa, com interposição de condutos preenchidos com 10 mL (cinco animais - grupo 1) e 1 mL (seis animais - grupo 2) de tinta da China. Após a eutanásia, os membros foram amputados e submetidos a análise histológica. RESULTADOS: Na microscopia óptica, o pigmento foi encontrado no lúmen de arteríolas de seis (55%) dos 11 porcos utilizados no experimento; quatro (80%) de cinco animais eram do grupo 1 e dois (33%) de seis animais eram do grupo 2. CONCLUSÕES: O modelo experimental utilizado foi capaz de testar a hipótese. A presença de tinta da China no lúmen arteriolar mostra que é possível alcançar o vaso arterial por meio de arterialização venosa.


Subject(s)
Animals , Guinea Pigs , Arteriovenous Fistula/therapy , Ischemia/prevention & control , Models, Animal , Microcirculation
15.
Bogotá; IETS; mayo 2016. tab, graf.
Monography in Spanish | LILACS, BRISA | ID: biblio-846778

ABSTRACT

Tecnologías evaluadas: Dabigatran, rivaroxaban y apixaban, comparado con warfarina. Población: Pacientes adultos con fibrilación auricular no valvular en Colombia. Perspectiva: Tercer pagador - Sistema General de Seguridad Social en Salud. Horizonte temporal: El horizonte temporal de esta AIP en el caso base corresponde a un año. Adicionalmente se reportan las estimaciones del impacto presupuestal para los años 2 y 3, bajo el supuesto de inclusión en el POS en el año 1. Costos incluidos: Costos directos del tratamiento de acuerdo a las alternativas evaluadas y seguimiento a los pacientes. Fuente de costos: Los medicamentos fueron costeados con la información del SISMED, para costear los procedimientos se empleó tarifario ISS2001. Escenarios: Escenarios de aumento de participación en el mercado y de disminución de precios acorde a los resultados de la evaluación económica paralela a este AIP. Resultados: En el escenario 1, la inclusión implicaría una inversión de 479.616.207.902 en el año 1, de $ 112.930.049.925 en el año 2 y de $ 145.201.625.581 en el año 3, en el escenario 2 implicaría una inversión $ 212.829.453.5 en el año 1, $ 54.400.081.439 en el año 2 y $ 69.849.046.563 en el año 3.(AU)


Subject(s)
Humans , Adult , Middle Aged , Aged , Atrial Fibrillation/drug therapy , Ischemia/prevention & control , Thromboembolism/prevention & control , Biomedical Technology , Colombia , Costs and Cost Analysis/methods , Dabigatran/therapeutic use , Factor Xa Inhibitors/therapeutic use , Health Evaluation/economics , Reproducibility of Results , Rivaroxaban/therapeutic use , Warfarin/therapeutic use
16.
Acta cir. bras ; 31(4): 264-270, Apr. 2016. tab, graf
Article in English | LILACS | ID: lil-781326

ABSTRACT

PURPOSE: To evaluated the potential antioxidant agent Legalon (r) SIL (silibinin-C-2',3-bis(hydrogensuccinat)) in the skeletal muscle of rats. METHODS: IRI was achieved via tourniquet application in Wistar-albino rats. Experimental groups were chosen as (i) sham control, (ii) IRI (3+2 h), (iii) IRI and Legalon (r) SIL-50 (50 mg/kg/i.p.), (iv) IRI and Legalon (r) SIL-100 (100 mg/kg/i.p.), and (v) IRI and Legalon (r) SIL-200 (200 mg/kg/ i.p.). Muscle viability (evaluated by triphenyltetrazolium chloride dye method), malondialdehyde, superoxide dismutase, catalase, and glutathione peroxidase were assessed in muscle samples using a spectrophotometer. RESULTS: Although viability of the injured limb non-significantly declined in the IRI group, administration of Legalon (r) SIL did not prevent injury. However, dramatic increase observed in malondialdehyde levels in the IRI group was prohibited by Legalon (r) SIL in a statistically significant manner. In comparison with the sham-control group, IRI and Legalon (r) SIL administration did not cause any significant alterations in the levels of superoxide dismutase, catalase, and glutathione peroxidase. CONCLUSION: Although Legalon (r) SIL was not sufficient to prevent muscle injury in terms of viability, it is found to be an effective option to reduce reactive oxygen species-induced cell injury.


Subject(s)
Animals , Male , Silymarin/pharmacology , Reperfusion Injury/prevention & control , Muscle, Skeletal/blood supply , Ischemia/prevention & control , Antioxidants/pharmacology , Reference Values , Superoxide Dismutase/analysis , Superoxide Dismutase/drug effects , Tissue Survival/drug effects , Catalase/analysis , Catalase/drug effects , Random Allocation , Reproducibility of Results , Reactive Oxygen Species/analysis , Rats, Wistar , Oxidative Stress/drug effects , Muscle, Skeletal/drug effects , Muscle, Skeletal/chemistry , Glutathione Peroxidase/analysis , Glutathione Peroxidase/drug effects , Malondialdehyde/analysis
17.
Int. braz. j. urol ; 42(1): 146-153, Jan.-Feb. 2016. tab, graf
Article in English | LILACS | ID: lil-777330

ABSTRACT

ABSTRACT Purpose To investigate the protective effects against ischemia reperfusion injury of dipyridamole in a model of induced priapism in rats. Materials and Methods Twenty-four male Sprague-Dawley rats were divided into four groups, control, P/R, P/R+DMSO and P/R+D. 3ml blood specimens were collected from vena cava inferior in order to determine serum MDA, IMA, TAS, TOS and OSI values, and penile tissue was taken for histopathological examination in control group. Priapism was induced in P/R group. After 1h, priapism was concluded and 30 min reperfusion was performed. In P/R+DMSO group 1ml/kg DMSO was administered intraperitoneally 30 min before reperfusion, while in P/R+D group 10mg/kg dipyridamole was administered intraperitoneally 30 min before reperfusion. Blood and penis specimens were collected after the end of 30 min reperfusion period. Sinusoidal area (µm2), tears in tunica albuginea and injury parameters in sinusoidal endothelium of penis were investigated. Results Histopathological examination revealed no significant changes in term of sinusoidal area. A decrease in tears was observed in P/R+D group compared to P/R group (p<0.05). Endothelial injury decreased in P/R+D group compared to P/R group (p>0.05). There were no significant differences in MDA and IMA values between groups. A significant increase in TOS and OSI values was observed in P/R+D group compared to P/R group. A significant decrease in TAS levels was observed in P/R+D group compared to the P/R group. Conclusions The administration of dipyridamole before reperfusion in ischemic priapism model has a potential protective effect against histopathological injury of the penis.


Subject(s)
Animals , Male , Penis/blood supply , Priapism/prevention & control , Vasodilator Agents/pharmacology , Reperfusion Injury/prevention & control , Dipyridamole/pharmacology , Ischemia/prevention & control , Penis/pathology , Priapism/pathology , Time Factors , Penile Erection/drug effects , Serum Albumin , Biomarkers/blood , Random Allocation , Reproducibility of Results , Treatment Outcome , Oxidants/blood , Rats, Sprague-Dawley , Oxidative Stress , Ischemic Preconditioning/methods , Disease Models, Animal , Serum Albumin, Human , Malondialdehyde/blood , Antioxidants/analysis
18.
J. bras. pneumol ; 42(1): 9-14, Jan.-Feb. 2016. graf
Article in Portuguese | LILACS | ID: lil-776473

ABSTRACT

Objective : To investigate the effects of N-acetylcysteine (NAC) and pentoxifylline in a model of remote organ injury after hind-limb ischemia/reperfusion (I/R) in rats, the lungs being the remote organ system. Methods : Thirty-five male Wistar rats were assigned to one of five conditions (n = 7/group), as follows: sham operation (control group); hind-limb ischemia, induced by clamping the left femoral artery, for 2 h, followed by 24 h of reperfusion (I/R group); and hind-limb ischemia, as above, followed by intraperitoneal injection (prior to reperfusion) of 150 mg/kg of NAC (I/R+NAC group), 40 mg/kg of pentoxifylline (I/R+PTX group), or both (I/R+NAC+PTX group). At the end of the trial, lung tissues were removed for histological analysis and assessment of oxidative stress. Results : In comparison with the rats in the other groups, those in the I/R group showed lower superoxide dismutase activity and glutathione levels, together with higher malondialdehyde levels and lung injury scores (p < 0.05 for all). Interstitial inflammatory cell infiltration of the lungs was also markedly greater in the I/R group than in the other groups. In addition, I/R group rats showed various signs of interstitial edema and hemorrhage. In the I/R+NAC, I/R+PTX, and I/R+NAC+PTX groups, superoxide dismutase activity, glutathione levels, malondialdehyde levels, and lung injury scores were preserved (p < 0.05 for all). The differences between the administration of NAC or pentoxifylline alone and the administration of the two together were not significant for any of those parameters (p > 0.05 for all). Conclusions : Our results suggest that NAC and pentoxifylline both protect lung tissue from the effects of skeletal muscle I/R. However, their combined use does not appear to increase the level of that protection.


Objetivo : Investigar os efeitos da N-acetilcisteína (NAC) e pentoxifilina em um modelo de lesão pulmonar remota após isquemia/reperfusão (I/R) de membro posterior em ratos. Métodos : Trinta e cinco ratos Wistar machos foram divididos em cinco grupos (n = 7/grupo), cada qual submetido ao seguinte: operação simulada (grupo controle); isquemia de membro posterior, induzida por pinçamento da artéria femoral esquerda por 2 h, seguida por de 24 h de reperfusão (grupo I/R); e isquemia de membro posterior, como descrito acima, seguida de injeção intraperitoneal (antes da reperfusão) de 150 mg/kg de NAC (grupo I/R+NAC), 40 mg/kg de pentoxifilina (grupo I/R+PTX) ou ambas (grupo I/R+NAC+PTX). Ao final do experimento, tecidos pulmonares foram removidos para análise histológica e avaliação do estresse oxidativo. Resultados : Comparados aos ratos dos outros grupos, os do grupo I/R apresentaram menor atividade de superóxido dismutase e menores níveis de glutationa, além de maiores níveis de malondialdeído e maiores escores de lesão pulmonar (p < 0,05 para todos). Infiltração celular inflamatória intersticial dos pulmões também foi bem maior no grupo I/R do que nos outros grupos. Além disso, os ratos do grupo I/R apresentaram vários sinais de edema intersticial e hemorragia. Nos grupos I/R+NAC, I/R+PTX e I/R+NAC+PTX, a atividade de superóxido dismutase, níveis de glutationa, níveis de malondialdeído e escores de lesão pulmonar foram preservados (p < 0,05 para todos). As diferenças entre a administração de NAC ou pentoxifilina isoladamente e a das duas combinadas não foi significativa para nenhum desses parâmetros (p > 0,05 para todos). Conclusões : Nossos resultados sugerem que tanto NAC quanto pentoxifilina protegem o tecido pulmonar dos efeitos de I/R de músculo esquelético. Entretanto, seu uso combinado não parece aumentar o nível dessa proteção.


Subject(s)
Animals , Male , Acetylcysteine/pharmacology , Free Radical Scavengers/pharmacology , Ischemia/prevention & control , Lung Injury/prevention & control , Lung/blood supply , Pentoxifylline/pharmacology , Reperfusion Injury/prevention & control , Acetylcysteine/therapeutic use , Disease Models, Animal , Free Radical Scavengers/therapeutic use , Glutathione/analysis , Hindlimb/blood supply , Lung Injury/pathology , Lung/drug effects , Lung/pathology , Malondialdehyde/analysis , Oxidative Stress , Pentoxifylline/therapeutic use , Random Allocation , Rats, Wistar , Reproducibility of Results , Superoxide Dismutase/analysis , Time Factors
19.
Acta cir. bras ; 30(11): 756-761, Nov. 2015. graf
Article in English | LILACS | ID: lil-767601

ABSTRACT

PURPOSE: To investigate the effects of remifentanil as an antioxidant and analyze the histopathologic, biochemical changes in experimental ischemia-reperfusion (I/R) exposed rat uteri. METHODS: Wistar albino rats were assigned to three groups (n = 7). 2h period of ischemia was followed by 1h of reperfusion in the I/R and the I/R-remifentanil groups. After ischemia, no drug was administered in the sham and I/R groups. In the I/R-remifentanil group, remifentanil infusion (2 μg/kg/min) was started in the ischemia period, and continued until the end of reperfusion. After the ischemic and reperfusion period, the ischemic uterine horns were removed surgically for biochemical and histopathologic examination. Tissue damage scores (endometrial epithelial glandular leukocytosis, degeneration, and endometrial stromal changes) were examined. Malondialdehyde levels and catalase, superoxide dismutase enzyme activities in tissue were measured. RESULTS: We found significantly lower epithelial leukocytosis and cell degeneration in the I/R-remifentanil group (p<0.05). Remifentanil administration significantly decreased concentrations of malondialdehyde, and increased catalase and superoxide dismutase enzyme activities (p<0.05). CONCLUSION: Remifentanil appears to protect the uterine tissue against ischemia-reperfusion and can be used safely in uterus transplantation.


Subject(s)
Animals , Female , Analgesics, Opioid/pharmacology , Ischemia/prevention & control , Piperidines/pharmacology , Reperfusion Injury/prevention & control , Uterus/blood supply , Antioxidants/pharmacology , Catalase/drug effects , Ischemia/pathology , Malondialdehyde/analysis , Random Allocation , Rats, Wistar , Reproducibility of Results , Reperfusion Injury/pathology , Superoxide Dismutase/drug effects , Time Factors , Uterus/pathology
20.
Acta cir. bras ; 30(11): 749-755, Nov. 2015. tab, graf
Article in English | LILACS | ID: lil-767602

ABSTRACT

PURPOSE: To evaluate the underlying mechanisms by which sevoflurane protects the liver against ischemia/reperfusion injury evaluate the mechanism by which sevoflurane exerts this protective effect. METHODS: Twenty-six rats were subjected to partial ischemia/reperfusion injury for 1h: one group received no treatment, one group received sevoflurane, and sham group of animals received laparotomy only. Four hours after reperfusion, levels of alanine and aspartate aminotransferases, tumor necrosis factor-a, and interleukins 6 and 10 were measured. Analyses of mitochondrial oxidation and phosphorylation, malondialdehyde content, histology, and pulmonary vascular permeability were performed. RESULTS: Serum levels of alanine and aspartate aminotransferases were significantly lower in the sevoflurane group compared to untreated controls (p<0.05). The sevoflurane group also showed preservation of liver mitochondrial function compared to untreated controls (p<0.05). Sevoflurane administration did not alter increases in serum levels of tumor necrosis factor-a, and interleukins 6 and 10. Sevoflurane treatment significantly reduced the coagulative necrosis induced by ischemia/reperfusion (p<0.05). Pulmonary vascular permeability was preserved in the sevoflurane group compared to untreated controls. CONCLUSION: Sevoflurane administration protects the liver against ischemia/reperfusion injury, via preservation of mitochondrial function, and also preserves lung vascular permeability.


Subject(s)
Animals , Male , Anesthetics, Inhalation/pharmacology , Ischemia/prevention & control , Liver/blood supply , Methyl Ethers/pharmacology , Mitochondria, Liver/drug effects , Reperfusion Injury/prevention & control , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Capillary Permeability/drug effects , Cytokines/blood , Ischemia/pathology , Lipid Peroxidation , Liver/pathology , Mitochondria, Liver/physiology , Necrosis , Phosphorylation , Rats, Wistar , Reproducibility of Results , Reperfusion Injury/pathology , Time Factors
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