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1.
Int. j. med. surg. sci. (Print) ; 8(2): 1-9, jun. 2021. tab, ilus
Article in English | LILACS | ID: biblio-1284417

ABSTRACT

Background:Lumbar sympathectomy through radio ablation is a useful treatment of peripheral ischemia. However, clinical efficacy with respect to lower limb ulcers is not adequately established in the Indian population. The study was conducted to evaluate the role of radiofrequency ablation (RFA) of the lumbar sympathetic ganglia in healing of ischemic ulcers of the lower limb.Method:The prospective study with 63 patients registered in the General surgery department with lower limb ischemic ulcers between December 2017­ July2019 were treated with RFA. Patients with cardiopulmonary disease, pregnant, congenital malformation, or skin infection at the site of intervention, or suffering from bleeding disorders, were excluded from the study. Clinical investigation of the wound was performed, and demographic data was collected. Comparative reduction in wound size was assessed through Friedman`s ANOVA (P<0.001). Difference in pain score, hospital stay, and walking distance were evaluated using Wilcoxon matched pair test (P<0.001), Unpaired t-test, and Paired t-test (P<0.05).Result:Majority of the patients were male (n=40) with a mean age of 60.93 SD14.34 years. Significant reduction in wound size, pain scores and hospital stay were observed post procedure(P<0.001). Number of RFA sessions was significantly associated with the size of the ulcer and Fontaine's classification 2 and 3 (P<0.0001).Conclusion:RFA of lumbar sympathetic ganglia is a potential treatment modality for lower limb ischemic ulcers.


Antecedentes: La simpatectomía lumbar a través de la ablación por radiofrecuencia es un tratamiento útil de la isquemia periférica. Sin embargo, la eficacia clínica con respecto a las úlceras en las extremidades inferiores no está adecuadamente establecida en la población india. El estudio se llevó a cabo para evaluar el papel de la ablación por radiofrecuencia (RFA) de los ganglios simpáticos lumbares en la curación de las úlceras isquémicas de la extremidad inferior. Método: El estudio prospectivo con 63 pacientes registrados en el departamento de cirugía general con úlceras isquémicas de las extremidades inferiores entre diciembre de 2017 y julio de 2019 fueron tratados con RFA. Los pacientes con enfermedad cardiopulmonar, malformación embarazada, congénita o infección de la piel en el lugar de la intervención, o que sufren de trastornos hemorrágicos, fueron excluidos del estudio. Se realizó una investigación clínica de la herida y se recopilaron datos demográficos. La reducción comparativa en el tamaño de la herida se evaluó a través del ANOVA de Friedman (P<0.001).Resultado: La diferencia en la puntuación del dolor, la estancia en el hospital y la distancia a pie se evaluaron mediante la prueba de par coincidente de Wilcoxon (P<0.001), la prueba t no emparejada y la prueba t emparejada (P<0.05). La mayoría de los pacientes eran varones (n-40) con una edad media de 60,93 SD14,34 años. Se observó una reducción significativa en el tamaño de la herida, las puntuaciones de dolor y la estancia hospitalaria (P<0.001). El número de sesiones de RFA se asoció significativamente con el tamaño de la úlcera y las clasificaciones 2 y 3 de Fontaine (P<0.0001).Conclusión: LA RFA de los ganglios simpáticos lumbares puede constituir una opción terapéutica para las úlceras isquémicas de las extremidades inferiores.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Ulcer/therapy , Lower Extremity , Radiofrequency Ablation/methods , Ganglia, Sympathetic , Ischemia/therapy , Prospective Studies , Analysis of Variance , India
2.
Rev. argent. cir. plást ; 25(1): 16-20, 20190000. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1358037

ABSTRACT

Propósito y objetivo. Demostrar una de las opciones más empleadas para la cobertura de úlceras isquiáticas en paciente parapléjico. El colgajo glúteo mayor sería de primera elección en el caso presentado de una paciente con diagnóstico de escaras isquiáticas bilateral Grado IV. Introducción. El colgajo glúteo mayor, colgajo musculocutáneo, es un procedimiento muy utilizado y de primera línea para el tratamiento de úlceras isquiáticas. Debemos tener en cuenta que para el éxito y buena evolución de la cirugía es necesario la conformación de un equipo multidisciplinario, para su seguimiento y control. Las opciones de cobertura dependen de la topografía de la lesión. Algunas de las opciones de cobertura son: colgajo glúteo inferior de rotación, colgajo glúteo inferior de avance en V-Y, colgajo de isquiotibiales en V-Y, colgajo de cara posterior de muslo y colgajo extendido de fascia lata, entre otros. Material y método. Se presenta el caso clínico de una paciente femenina con diagnóstico patológico de cavernoma intramedular D9, que padece paraplejía de un año de evolución, presentando escara isquiática bilateral grado IV acompañadas de osteomielitis. Se trató quirúrgicamente con colgajo glúteo mayor bilateral Resultados. En esta paciente se alcanzó una adecuada cobertura del defecto, que permitió su pronta rehabilitación, y un minucioso control posoperatorio que no mostró complicaciones ni recidiva, hasta la fecha. Discusión. Las úlceras isquiáticas profundas ubicadas cerca del tracto genitourinario presentan mayor dificultad para su reconstrucción. El colgajo musculocutáneo de glúteo mayor a pedículo inferior permite el cierre de cualquier úlcera isquiática y el cierre primario del sitio donador asegurando un cierre sin tensión; otras opciones quirúrgicas, como los colgajos basados en la pelvis o el tronco, son menos susceptibles a la tensión que aquellos ubicados en la porción móvil de la extremidad inferior, por lo que los colgajos de glúteo mayor, inferior y de cara posterior al muslo tienen mayor porcentaje de éxito que los colgajos de tensor de fascia lata e isquiotibiales. Conclusión. El colgajo glúteo mayor es un tratamiento de primera elección para la cobertura de úlceras isquiáticas de alta morbilidad en pacientes parapléjicos, tratado por un equipo multidisciplinario, cuya técnica quirúrgica presentó buena cobertura con un control estricto del posoperatorio con excelente evolución y sin ninguna complicación esperada


Subject(s)
Humans , Female , Adult , Paraplegia/drug therapy , Sciatica/pathology , Surgical Flaps/blood supply , Buttocks/surgery , Aftercare , Reconstructive Surgical Procedures/methods , Pressure Ulcer/surgery , Ischemia/therapy
3.
Braz. arch. biol. technol ; 62: e19190055, 2019. graf
Article in English | LILACS | ID: biblio-1055417

ABSTRACT

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


Subject(s)
Animals , Rats , Myocardial Reperfusion , Ischemia/therapy , Cardiotonic Agents/administration & dosage , Apoptosis , Oxidative Stress , Models, Animal , Rosuvastatin Calcium/administration & dosage
4.
Braz. arch. biol. technol ; 62: e19180438, 2019. tab, graf
Article in English | LILACS | ID: biblio-1055415

ABSTRACT

Abstract Possible protective effects of geraniol, known as antioxidant properties, were analyzed biochemically and histologically on experimental long-term renal ischemia/reperfusion I/R injury in rats. This study used 3-4 months old male Wistar albino rats and were divided into 4 groups (n = 7) by random selection: Group I (Sham Group), Group II (I/R+SF), Group III (I/R+50 mg/kg geraniol), and Group IV (I/R+100 mg/kg geraniol). A right nephrectomy was performed in all groups under anesthesia. Groups I and II were inoculated with SF (1 ml/kg) and Groups III and IV were inoculated with 50 mg/kg and 100 mg/kg of geraniol, injected intraperitoneally. For Groups II, III, and IV, I/R durations were determined to be 60 mins ischemia and 24 hours reperfusion. At the end of the experiment, Urea (BUN), Creatinine (CRE) activities in the blood serum and the catalase (CAT), glutathione peroxidase (GPx) and Superoxide dismutases (SOD), enzyme activities in kidney tissue were measured. Histologic sections were examined by light microscopy using Hematoxylin & Eosine. As a result, it was determined that 100 mg / kg geraniol against renal I/R injury shows more antioxidant effect and protection than 50 mg / kg geraniol.


Subject(s)
Animals , Rats , Reperfusion , Ischemia/therapy , Antioxidants/therapeutic use , Rats, Wistar , Models, Animal , Protective Factors
5.
Rev. Col. Bras. Cir ; 46(5): e20192260, 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1057172

ABSTRACT

RESUMO Objetivo: avaliar o uso do curativo de filme e gel de biopolímero de celulose bacteriana no tratamento de pacientes com feridas isquêmicas submetidos à revascularização dos membros inferiores. Métodos: ensaio clínico randomizado realizado no ambulatório de Angiologia e Cirurgia Vascular do Hospital das Clínicas da Universidade Federal de Pernambuco, entre janeiro de 2017 e dezembro de 2018. Foram acompanhados 24 pacientes após revascularização de membros inferiores, divididos em dois grupos: Experimental, tratado com filme e gel de biopolímero de celulose bacteriana, e Controle, tratado com ácidos graxos essenciais. Os pacientes foram acompanhados em consultas semanais para troca dos curativos e o processo de cicatrização das feridas foi avaliado em um período de 90 dias. Resultados: a redução da área das feridas isquêmicas no período de 30 dias foi de 4,3cm2 (55%), em média, para o grupo experimental, e de 5,5cm2 (48,5%) para o grupo controle (p>0,05). A taxa de cicatrização completa, em 90 dias, foi de 34,8%, sendo 50% no grupo experimental e 18,2% no grupo controle (p=0,053). Conclusão: o filme de biopolímero de celulose bacteriana associada a gel pode ser utilizado como curativo no tratamento de feridas isquêmicas de pacientes submetidos à revascularização de membros inferiores


ABSTRACT Objective: to evaluate the use of a bacterial cellulose biopolymer film and gel dressing in the treatment of patients with ischemic wounds submitted to lower limb revascularization. Methods: we conducted a randomized clinical trial in the Angiology and Vascular Surgery outpatient clinic of the Clinics Hospital of the Federal University of Pernambuco, between January 2017 and December 2018. We followed 24 patients after lower limb revascularization, divided into two groups: Experimental, treated with bacterial cellulose biopolymer film and gel, and Control, treated with essential fatty acids. Patients attended weekly appointments to change dressings and had their wound healing processes evaluated over a period of 90 days. Results: the reduction of the ischemic wounds' areas after 30 days was 4.3cm2 (55%) on average for the experimental group, and the 5.5cm2 (48.5%) for the control group (p>0.05). The complete healing rate at 90 days was 34.8%, 50% in the experimental group and 18.2% in the control group (p=0.053). Conclusion: the bacterial cellulose biopolymer film associated with gel can be used as a dressing in the treatment of ischemic wounds of patients undergoing revascularization of the lower limbs.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Bandages , Wound Healing/drug effects , Biopolymers/therapeutic use , Cellulose/therapeutic use , Lower Extremity/pathology , Ischemia/complications , Ischemia/therapy , Time Factors , Treatment Outcome , Angioplasty , Lower Extremity/blood supply , Gels/therapeutic use , Ischemia/pathology , Middle Aged
6.
Acta cir. bras ; 33(8): 723-735, Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-949372

ABSTRACT

Abstract It is well known that during hepatic operative procedures, it is often critical that the irrigation is interrupted to avoid possible bleeding, blood transfusions, variable intensities, and their short and long-term consequences. It was believed in the past that the flow interruption should not exceed 20 minutes, which limited the use of this maneuver. However, it has been postulated that ischemia could be maintained for more than 60 minutes in healthy livers. The present paper review includes: 1) A brief introduction to justify the rationale of the review design; 2) Aspects of the pathophysiology of the three stages of the liver ischemia-reperfusion injury; 3) The innate and acquired immunity; 4) Oxidative stress; 5) Apoptosis and autophagy, Some essential biomarkers (Tumor Necrosis Factor-α, nitric oxide, metalloproteinases); and, finally; 6) Preventive ("cheating") strategies, non-pharmacological and pharmacological options to treat the liver IR injury.


Subject(s)
Humans , Reperfusion Injury/physiopathology , Reperfusion Injury/therapy , Ischemic Preconditioning/methods , Ischemia/physiopathology , Ischemia/therapy , Liver/blood supply , Time Factors , Mitochondria, Liver/metabolism , Reperfusion Injury/metabolism , Tumor Necrosis Factor-alpha/metabolism , Cell Death/physiology , Oxidative Stress/physiology , Matrix Metalloproteinases/metabolism , Ischemia/metabolism , Nitric Oxide/metabolism
7.
Article in Portuguese | LILACS | ID: biblio-883880

ABSTRACT

Objetivos: expor de forma sucinta e objetiva as principais características da síndrome de oclusão arterial aguda, além de sua importância do ponto de vista epidemiológico, tendo em vista a elevada morbidade e mortalidade em nosso meio. Propõe-se a discussão do quadro clínico, o reconhecimento das características de cada tipo de oclusão e a possibilidade de reversão do quadro. Métodos: revisão de literatura realizada entre abril e junho de 2017 no banco de dados PubMed, através do uso dos termos chaves "membros", "isquemia", "revascularização" e "oclusão arterial aguda". Resultados: a oclusão arterial aguda consiste numa das mais dramáticas complicações da doença arterial periférica; porém, apresenta potencialidade de reversão, apresentando taxas de salvamento de membros de 85%, se reconhecida e prontamente tratada. Conclusão: A elevada morbimortalidade dessa patologia faz com que sejam envidados todos os esforços na tentativa de se obter o diagnóstico precoce, permitindo uma terapêutica ágil e resolutiva, diminuindo o número de amputações e mortes.


Aims: to present a brief and objective analysis of the main characteristics of the acute arterial occlusion syndrome, in addition to its epidemiological importance, considering the high morbidity and mortality in our country. It is proposed to discuss the clinical picture, the recognition of the characteristics of each type of occlusion and the possibility of reversion of the condition. Methods: literature review performed between April and June 2017 in the PubMed database, using the key terms "limbs", "ischemia", "revascularization" and "acute limb ischemia". Results: acute limb ischemia is one of the most dramatic complications of peripheral arterial disease; however, it has a potential for reversion, presenting limb salvage rates of 85%, if recognized and promptly treated. Conclusion: the high morbidity and mortality of this pathology means that all efforts must be made in the attempt to obtain the early diagnosis, allowing agile and resolutive therapy, decreasing the number of amputations and deaths.


Subject(s)
Ischemia/diagnosis , Ischemia/therapy , Peripheral Arterial Disease , Acute Disease , Embolism , Thrombosis
9.
Rev. bras. cir. cardiovasc ; 30(3): 353-359, July-Sept. 2015. tab, ilus
Article in English | LILACS | ID: lil-756517

ABSTRACT

AbstractObjective:To assess the effects of postconditioning remote in ischemia-reperfusion injury in rat lungs.Methods:Wistar rats (n=24) divided into 3 groups: GA (I/R) n=8, GB (R-Po) n=8, CG (control) n=8, underwent ischemia for 30 minutes artery occlusion abdominal aorta, followed by reperfusion for 60 minutes. Resected lungs and performed histological analysis and classification of morphological findings in accordance with the degree of tissue injury. Statistical analysis of the mean rating of the degree of tissue injury.Results:GA (3.6), GB (1.3) and CG (1.0). (GA GB X P<0.05).Conclusion:The remote postconditioning was able to minimize the inflammatory lesion of the lung parenchyma of rats undergoing ischemia and reperfusion process.


ResumoObjetivo:Avaliar os efeitos do pós-condicionamento remoto no fenômeno de isquemia e reperfusão nos pulmões de ratos.Métodos:Ratos Wistar (n=24) divididos em 3 grupos: GA (I/R) n=8, GB pós-condicionamento remoto n=8, GC (controle) n=8, submetidos à isquemia de 30 minutos por oclusão da artéria aorta abdominal, seguida de reperfusão de 60 minutos. Ressecados os pulmões e realizada a análise histológica e classificação dos achados morfológicos de acordo com o grau de lesão tecidual. Análise estatística das médias da classificação do grau de lesão tecidual.Resultados:GA (3,6); GB (1,3) e GC (1,0). (GA X GB P<0,05).Conclusão:O pós-condicionamento remoto foi capaz de minimizar a lesão inflamatória do parênquima pulmonar de ratos submetidos ao processo de isquemia e reperfusão.


Subject(s)
Animals , Male , Ischemic Postconditioning/methods , Lung/blood supply , Reperfusion Injury/prevention & control , Ischemia/therapy , Lung/pathology , Pneumonia/prevention & control , Random Allocation , Rats, Wistar , Reproducibility of Results , Reperfusion Injury/pathology , Severity of Illness Index , Time Factors , Treatment Outcome
10.
Gastroenterol. latinoam ; 26(supl.1): S37-S39, 2015.
Article in Spanish | LILACS | ID: biblio-868974

ABSTRACT

Intestinal ischemia remains a high risk mortality disease. Early detection has a huge impact in survival. The development of new biochemical markers will be useful in ischemia screening. Computed tomography (CT) scan and AngioTC, has a great value to assess viability of small bowel areas. Basic treatment and even surgery have the best results in early diagnosis setting.


La isquemia intestinal continúa siendo una patología de alto riesgo de mortalidad. El reconocimiento clínico precoz tiene impacto en la sobrevida. Se están desarrollando nuevos marcadores bioquímicos para optimizar la pesquisa de isquemia. En estos casos, la tomografía computada (TC) multicorte y angioTC, son de gran utilidad para establecer la viabilidad de un segmento y la probabilidad de resección. En tratamiento general y quirúrgico si corresponde, tiene mejores resultados en escenarios de diagnóstico precoz.


Subject(s)
Humans , Intestines/blood supply , Ischemia/diagnosis , Ischemia/therapy , Biomarkers , Early Diagnosis , Risk Factors
11.
Braz. j. med. biol. res ; 47(10): 886-894, 10/2014. graf
Article in English | LILACS | ID: lil-722168

ABSTRACT

Administration or expression of growth factors, as well as implantation of autologous bone marrow cells, promote in vivo angiogenesis. This study investigated the angiogenic potential of combining both approaches through the allogenic transplantation of bone marrow-derived mesenchymal stem cells (MSCs) expressing human basic fibroblast growth factor (hbFGF). After establishing a hind limb ischemia model in Sprague Dawley rats, the animals were randomly divided into four treatment groups: MSCs expressing green fluorescent protein (GFP-MSC), MSCs expressing hbFGF (hbFGF-MSC), MSC controls, and phosphate-buffered saline (PBS) controls. After 2 weeks, MSC survival and differentiation, hbFGF and vascular endothelial growth factor (VEGF) expression, and microvessel density of ischemic muscles were determined. Stable hbFGF expression was observed in the hbFGF-MSC group after 2 weeks. More hbFGF-MSCs than GFP-MSCs survived and differentiated into vascular endothelial cells (P<0.001); however, their differentiation rates were similar. Moreover, allogenic transplantation of hbFGF-MSCs increased VEGF expression (P=0.008) and microvessel density (P<0.001). Transplantation of hbFGF-expressing MSCs promoted angiogenesis in an in vivo hind limb ischemia model by increasing the survival of transplanted cells that subsequently differentiated into vascular endothelial cells. This study showed the therapeutic potential of combining cell-based therapy with gene therapy to treat ischemic disease.


Subject(s)
Animals , Humans , Male , Extremities/blood supply , /metabolism , Gene Expression , Ischemia/physiopathology , Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells/metabolism , Neovascularization, Physiologic/physiology , Antigens, Surface/analysis , Bone Marrow Cells/metabolism , Cell Differentiation , Disease Models, Animal , Green Fluorescent Proteins , Ischemia/therapy , Mesenchymal Stem Cells/cytology , Muscle, Skeletal/blood supply , Random Allocation , Rats, Sprague-Dawley , Transplantation, Homologous , Vascular Endothelial Growth Factor A/metabolism
13.
J. vasc. bras ; 13(3): 257-261, Jul-Sep/2014. graf
Article in English | LILACS | ID: lil-727131

ABSTRACT

Critical ischemia of a lower limb is a condition that threatens its viability and must be treated promptly to avoid major amputation. Revascularization is the most effective treatment method and is performed using surgical or endovascular techniques. For patients with thoracoabdominal aortic aneurysms, combining these two approaches into a "hybrid technique" makes it possible to treat patients who could not be adequately treated by either technique in isolation. We report on a case of lower limb critical ischemia treated using a combination of surgery and endovascular techniques, in an application of the hybrid technique in a different arterial bed...


A isquemia crítica de membro inferior é uma condição que constitui uma ameaça à viabilidade do membro e deve ser prontamente tratada para evitar uma amputação maior. A revascularização é o tratamento mais eficaz, podendo ser por técnica cirúrgica ou endovascular. Nos pacientes com aneurisma toracoabdominal da aorta, a combinação das duas técnicas, denominada técnica híbrida, permite ampliar a possibilidade de tratamento de pacientes que não seriam adequadamente tratados por nenhuma das duas técnicas isoladamente. Descrevemos o tratamento de uma isquemia crítica de membro inferior utilizando a combinação de cirurgia convencional e tratamento endovascular, também se constituindo, assim, em uma técnica híbrida, mas em outro território arterial...


Subject(s)
Humans , Female , Aged , Arterial Occlusive Diseases/surgery , Ischemia/therapy , Endovascular Procedures/rehabilitation , Angiography/methods , Angioplasty/methods , Comorbidity , Echocardiography, Doppler , Lower Extremity/physiopathology , Heparin/therapeutic use
14.
Acta cir. bras ; 29(supl.3): 17-21, 2014. tab, graf
Article in English | LILACS | ID: lil-726242

ABSTRACT

PURPOSE: To evaluate effects of ischemic preconditioning and Cilostazol on muscle ischemia-reperfusion injury. METHODS: Male Wistar rats were submitted to muscle ischemic and reperfusion injury (4h of the left common iliac artery occlusion followed by 1h of reperfusion). Five experimental groups were constituted: Control group (n=4); Ischemia-Reperfusion (IR, n=5); Ischemic preconditioning group (IP, n=6); Ischemia-Reperfusion group treated with cilostazol (IRCi, n=6) and Ischemic preconditioning group treated with cilostazol (IPCi, n=6). At the end, left gracile muscle was removed and embedded in paraffin. Histopathology, neutrophil infiltration, myocyte necrosis and edema were analyzed. RESULTS: When compared with the control group, IR group showed increased neutrophil infiltration, severe necrosis and edema. There was significant difference between myocytes necrosis of IR group and IP group. There was no difference between the histopathological changes between IP, IRCi and IPCi groups. CONCLUSIONS: The model of IR caused severe muscle injury in the rat hind limb and ischemic preconditioning has a protective effect, reducing myocyte necrosis, however, treatment with cilostazol and also the association between cilostazol and preconditioning has no protective effect on the skeletal muscle subjected to ischemia and reperfusion injury. .


Subject(s)
Animals , Male , Ischemia/therapy , Ischemic Preconditioning/methods , Muscle, Skeletal/blood supply , Reperfusion Injury/therapy , Tetrazoles/pharmacology , Hindlimb , Ischemia/physiopathology , Ischemic Preconditioning/adverse effects , Models, Animal , Muscle Fibers, Skeletal/drug effects , Muscle Fibers, Skeletal/pathology , Muscle, Skeletal/physiopathology , /pharmacology , Random Allocation , Rats, Wistar , Reperfusion Injury/physiopathology
15.
Yonsei Medical Journal ; : 46-52, 2014.
Article in English | WPRIM | ID: wpr-86942

ABSTRACT

PURPOSE: Metabolic syndrome (MS) is a clinical condition that shares many common characteristics with diabetes. However, unlike diabetes, the usefulness of MS as a prognostic entity in peripheral arterial disease is uncertain. This study evaluated the prognostic usefulness of MS in critical lower limb ischemia (CLI) patients. MATERIALS AND METHODS: We compared the 2-year clinical outcomes in 101 consecutive CLI patients (66+/-14 years; 78% men) with 118 affected limbs treated with percutaneous transluminal angioplasty (PTA) according to the presence of MS and diabetes. RESULTS: The number of MS patients was 53 (52%), of which 45 (85%) had diabetes. During a 2-year follow-up, the incidence of clinical outcomes, including reintervention, major amputation, minor amputation, and survival, was not significantly different between MS and non-MS patients; however, the incidence of minor amputation was significantly higher in diabetic than in non-diabetic patients (42% vs. 17%; p=0.011). Cox regression analysis for the 2-year primary patency demonstrated no association between MS and 2-year primary patency [hazard ratio (HR), 1.02; 95% confidence interval (CI), 0.45-2.30; p=0.961], whereas there was a significant association between diabetes and 2-year primary patency (HR, 2.81; 95% CI, 1.02-7.72; p=0.046). Kaplan-Meier analysis revealed no significant difference in the 2-year primary patency between MS and non-MS patients; however, the 2-year primary patency was lower in diabetic than in non-diabetic patients (p=0.038). CONCLUSION: As a prognostic concept, MS might conceal the adverse impact of diabetes on the prognosis of CLI patients treated with PTA.


Subject(s)
Aged , Aged, 80 and over , Angioplasty/methods , Diabetes Mellitus/therapy , Female , Humans , Ischemia/therapy , Lower Extremity/blood supply , Male , Metabolic Syndrome/therapy , Middle Aged , Republic of Korea , Retrospective Studies
16.
Article in English | WPRIM | ID: wpr-216492

ABSTRACT

Adipose stem cells (ASCs) are a type of adult stem cells that share common characteristics with typical mesenchymal stem cells. In the last decade, ASCs have been shown to be a useful cell resource for tissue regeneration. The major role of regenerative medicine in this century is based on cell therapy in which ASCs hold a key position. Active research on this new type of adult stem cell has been ongoing and these cells now have several clinical applications, including fat grafting, overcoming wound healing difficulties, recovery from local tissue ischemia, and scar remodeling. The application of cultured cells will increase the efficiency of cell therapy. However, the use of cultured stem cells is strictly controlled by government regulation to ensure patient safety. Government regulation is a factor that can limit more versatile clinical application of ASCs. In this review, current clinical applications of ASCs in plastic surgery are introduced. Future stem cell applications in clinical field including culturing and banking of ASCs are also discussed in this review.


Subject(s)
Adipose Tissue/cytology , Cicatrix/prevention & control , Humans , Ischemia/therapy , Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells/cytology , Surgery, Plastic , Tissue Engineering , Wound Healing
17.
Clinics ; 68(11): 1440-1445, 1jan. 2013. tab, graf
Article in English | LILACS | ID: lil-690628

ABSTRACT

OBJECTIVE: Our aim was to investigate the effects of growth hormone (GH), hyperbaric oxygen and combined therapy on normal and ischemic colonic anastomoses in rats. METHODS: Eighty male Wistar rats were divided into eight groups (n = 10). In the first four groups, non-ischemic colonic anastomosis was performed, whereas in the remaining four groups, ischemic colonic anastomosis was performed. In groups 5, 6, 7, and 8, colonic ischemia was established by ligating 2 cm of the mesocolon on either side of the anastomosis. The control groups (1 and 5) received no treatment. Hyperbaric oxygen therapy was initiated immediately after surgery and continued for 4 days in groups 3 and 4. Groups 2 and 6 received recombinant human growth hormone, whereas groups 4 and 8 received GH and hyperbaric oxygen treatment. Relaparotomy was performed on postoperative day 4, and a perianastomotic colon segment 2 cm in length was excised for the detection of biochemical and mechanical parameters of anastomotic healing and histopathological evaluation. RESULTS: Combined treatment with hyperbaric oxygen and GH increased the mean bursting pressure values in all of the groups, and a statistically significant increase was noted in the ischemic groups compared to the controls (p<0.05). This improvement was more evident in the ischemic and normal groups treated with combined therapy. In addition, a histopathological evaluation of anastomotic neovascularization and collagen deposition showed significant differences among the groups. CONCLUSIONS: Combined treatment with recombinant human growth hormone and hyperbaric oxygen resulted in a favorable therapeutic effect on the healing of ischemic colonic anastomoses. .


Subject(s)
Animals , Male , Rats , Colon/surgery , Human Growth Hormone/therapeutic use , Hyperbaric Oxygenation/methods , Ischemia/therapy , Wound Healing/drug effects , Anastomosis, Surgical , Combined Modality Therapy , Collagen/analysis , Colon/blood supply , Colon/pathology , Disease Models, Animal , Necrosis , Neovascularization, Physiologic , Pressure , Rats, Wistar , Reproducibility of Results , Treatment Outcome
18.
Rev. argent. ultrason ; 12(1): 28-35, mar. 2013. ilus
Article in Spanish | LILACS | ID: lil-671872

ABSTRACT

Definición, clínica, evolución, y etiología de esta anomalía, causante de isquemia arterial aguda, una emergencia médica que requiere diagnóstico y tratamiento tempranos


Subject(s)
Humans , Male , Female , Ductus Arteriosus/abnormalities , Ductus Arteriosus , Ischemia/classification , Ischemia/diagnosis , Ischemia/etiology , Ischemia/therapy
19.
Acta cir. bras ; 28(2): 126-130, Feb. 2013. graf
Article in English | LILACS | ID: lil-662360

ABSTRACT

PURPOSE: To investigate the consequences of the association between hyperbaric oxygen therapy and hepatic ischemia / reperfusion. METHODS: Wistar rats were divided into three groups: SHAM, rats submitted to surgical stress and anesthetic but not hepatic ischemia or reperfusion, I / R, rats submitted to total hepatic pedicle ischemia for 30 min, followed by 5 min of reperfusion; HBO120, rats submitted to 120 min of hyperbaric oxygen therapy at two absolute atmospheres and immediately after submitted to the experimental protocol of ischemia and reperfusion. The preservation of the hepatic function was evaluated by determining mitochondrial swelling and malondialdehyde tissue level, as well as alanine aminotransferase and aspartate aminotranferase serum levels. The results were analyzed using the Mann-Whitney test and differences were considered significant for p<0.05. RESULTS: There were significant differences in values: mitochondrial swelling of the I / R group compared to SHAM and HBO120; malondialdehyde between SHAM vs. I / R, SHAM vs HBO120, and I / R vs HBO120, alanine aminotransferase between SHAM vs. I / R . There was no significant difference between groups in aspartate aminotransferase serum levels. CONCLUSION: The association between hyperbaric oxygen therapy and hepatic ischemia and reperfusion process was positive.


Subject(s)
Animals , Male , Rats , Hyperbaric Oxygenation , Ischemia/therapy , Liver/blood supply , Reperfusion Injury/therapy , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Disease Models, Animal , Ischemia/pathology , Liver/pathology , Malondialdehyde/chemistry , Mitochondrial Swelling/physiology , Rats, Wistar , Statistics, Nonparametric
20.
Acta cir. bras ; 28(1): 5-9, jan. 2013. ilus, tab
Article in English | LILACS | ID: lil-662341

ABSTRACT

PURPOSE: To compare fluid replacement therapy with Hydroxyethyl starch 6% (HES) versus Ringer's lactate (RL) in a rodent model of non-septic renal ischemia. METHODS: Forty male Wistar rats were randomized to receive HES 2 ml.kg-1.hr-1or RL 5 ml. kg-1.hr-1 that underwent 30 minutes of renal ischemia followed by reperfusion. Twelve hours after kidney ischemia, the kidneys were evaluated for histological changes. Serum NGAL levels were obtained at different times of the experimental protocol. RESULTS: Rodents in the HES group had a median (IQR) grade of renal injury 3 (3 to 5) compared to 2 (2 to 4) in the RL group (p=0.03). NGAL levels were not associated with the severity of kidney injury. CONCLUSION: Hydroxyethyl starch administration caused more kidney injury than Ringer's lactate in a non-infectious model of renal hypoperfusion.


Subject(s)
Animals , Male , Rats , Acute Kidney Injury/therapy , Hydroxyethyl Starch Derivatives/therapeutic use , Ischemia/therapy , Isotonic Solutions/therapeutic use , Kidney/blood supply , Plasma Substitutes/therapeutic use , Acute-Phase Proteins , Acute Kidney Injury/pathology , Fluid Therapy/methods , Hemodynamics , Ischemia/pathology , Kidney/pathology , Lipocalins/blood , Oncogene Proteins/blood , Random Allocation , Rats, Wistar , Reproducibility of Results , Time Factors , Treatment Outcome
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